Edition May 2020

FORM 13.b

AMASEZERANO Y’IHEREREKANYA RY’UBUTAKA

RISHINGIYE KU BUGURE

Njyewe ………………………………………………………................................

Ufite Indangamuntu nimero:

Ufatanyije ubutaka na ………………………………………………….

Ufite Indangamuntu nimero:

Ubarizwa/babarizwa mu:

- Akarere:...................................................................
- Umurenge:................................................................
- Akagali:....................................................................
- Umudugudu...............................................................

Hashingiwe ku bwishyu bw’amafaranga y’ihererekanya ry’umutungo utimukanwa angana n’Ibihumbi mirongo

itatu y’u Rwanda (30,000Frw), nkuko bigaragazwa na gitansi yometse kuri aya masezerano ifite nomero
........………………;

Ngurishije/tugurishije/mpaye/duhaye umugabane ungana na……..%

Bwana/Madamu……………………………………………………………………….........

Ufite Indangamuntu nimero:

Hamwe na ……………………………………………………………..

Ufite indangamuntu nimero

Ubarizwa/babarizwa mu:

- Akarere:................................................................
- Umurenge:............................................................
- Akagali:.................................................................
- Umudugudu............................................................

Ubutaka burangwa n’ibi bikurikira:

 - UPI:......./…...../......../......../……
- Icyo ubutaka bugenewe gukoreshwa:..............................................................
- Aho buherereye: Intara:....................Akarere:......................;Umurenge:......................;
Akagali:................................; Umudugudu:................................

Ugurisha/abagurisha/utanze/abatanze yemeye/bemeye ko umutungo w’ubutaka n’ibyabukoreweho ari uwe/

uwabo kandi ukaba ugurishijwe ku kiguzi1 kingana na Frw..........................., agizwe na Frw…………….
y’ikiguzi cy’ubutaka hamwe na Frw …………………………. y’ikiguzi cy’ibyabukorewe (inzu, imyaka, ibindi).

Mpaye/duhaye Umubitsi w’Impapurompamo z’Ubutaka uburenganzira bwo kwandika ubu butaka ku

uwabuguze/ababuguze muri rejisitiri y’ubutaka.

Ku mugereka w’aya masezerano hometse ibyangombwa byose biranga ubu butaka kandi bigaragaza
nyirabwo/ ba nyirabwo.

Bishyizweho umukono kuri uyu munsi wa............../............../…………

Ugurisha/Abagurisha

1. ....................................................................................................... Umukono : ……………………..

2. …………………………………………………………………………… Umukono : ………………………

Uguze/Abagurisha/utanze/Abahawe

1. ....................................................................................................... Umukono : ………………………

2. …………………………………………………………………………… Umukono : ………………………

1 Ahagenewe ikiguzi ntihuzuzwa mu gihe ari ihererekanya rishingiye ku mpano cyangwa indagano.
 AHA HUZUZWA N’UBUYOBOZI BWEMEZA IHEREREKANYA GUSA

Twebwe, …………………………………………………………….., Noteri mu by’ubutaka mu Murenge wa

……………………………… twemeje ko iyi nyandiko y’amasezerano yanditse haruguru itugejejweho kugirango
yandikwe kuri uyu mwaka wa ………….., tariki ya................... z’ukwezi kwa ................ kandi ko aya
masezerano yujuje ibisabwa byose abagurisha/ugurisha n’abagura/ugura ubutaka basabwa mu ihererekanya
kandi ko amafaranga y’ihererekanya ry’ubu butaka na servisi zijyana nabyo angana na ibihumbi mirongo itatu
(30,000FRW) yishyuwe.

Turemeza kandi ko imyirondoro yabo n’imikono yabo biri hejuru ari impamo.

Nomero ............../.............../ byanditswe mu mwaka wa ………….., umunsi wa ..........., Ukwezi kwa

………………

________________________________________
Noteri mu by’ubutaka