Edition Nov

May2014
2018 FORM 5
INYANDIKO ISABA IHEREREKANYA RY’UBURENGANZIRA KU BUTAKA
RISHINGIYE KU CYEMEZO CY’URUKIKO
Umwirondoro
Njyewe/Twebwe: .....…………………………………………………………………………………………………………………...........
Irangamimerere: …………………………….…………………………………………………………………..........................................
Indangamuntu/Pasiporo: …………………..………………………………………………………………………………………..........
Aderesi: Akarere ka…………………….…. Umurenge wa ……………………………Akagari ka ……………………............
Umudugudu wa ………………................Telefoni : ………………………………………... E-mail: ……................……………...
Cyangwa
Isosiyete/ONG/Ishyirahamwe ry’umwuga/Idini/Koperative/Ibindi…………………………………………….........
Njyewe (Uhagarariye mu buryo bwemewe n'amategeko):………………………………….............................................
Indangamuntu/Pasiporo: ……......………………………………………………………………………………………………………..
Aderesi: Akarere ka…………………….…. Umurenge wa ……………………………Akagari ka ……………………............
Umudugudu wa ………………................Telefoni : ………………………………………... E-mail: ……................……………...

Ndasaba gukorerwa ihererekanya ry’uburenganzira ku butaka rishingiye ku cyemezo cy’urukiko

Amakuru ku kibanza/Isambu
Nimero y'ikibanza/isambu (UPI): …………………………....................................
Umujyi wa Kigali/Intara: ………………………………………..................
Akarere: …………………………………………………...
Umurenge: …………………………………….……………..
Akagari: …………………………………….……………..
Umugabane uhererekwanywa: ..................%
Ibisobanuro k'ubusabe………………………………………………………………………………………….....................................
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Ibisabwa
Kopi y’ibiranga usaba/abasaba ihererekanya
Icyemezo cy’urukiko gitegeka ihererekanya n’Inyandikomvugo y’irangizarubanza igaragaza nimero
y’ubutaka (Iyo nimero y’ubutaka itazwi : Ifishi y’ibipimo by'ubutaka (Fiche Cadastrale) yemejwe
n’umukozi w'Akarere ubifitiye ububasha n’inyandiko yakozwe n’umuhesha w’inkiko yemeza ko
ibipimo by’ubutaka byafashwe nk’uko urubanza rwarangijwe)
Icyemezo cyo kuba warashyingiwe/Icyemezo cy’uko uri ingaragu cy’usaba ihererekanya
Ibyangombwa by’ubutaka burebwa n’ihererekanya1 (Iyo uwanditse ku butaka bwavuzwe mu
rubanza yanze kugarura ibyangombwa by’ubutaka, umuhesha w'inkiko abigaragaza mu
nyandikomvugo y'irangizarubanza).
Inyandiko y’ubumvikane yakorewe imbere ya Noteri igaragaza imigabane buri muntu afite mu
gihe mu bagomba kwandikwa ku butaka harimo abanyamahanga bafatanyije ubutaka
n’Abanyarwanda cyangwa iyo ari isosiyete y’ubucuruzi, umuryango cyangwa ishyirahamwe
bifite ubuzima gatozi abanyamahanga bafitemo imigabane

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Itariki y'ubusabe Umukono w'usaba (w'abasaba)
Byakiriwe kandi bisuzumwa na: ………………………………...................................................................................................

Icyo ashinzwe:……………………………………………………………………………………………………………………………..................................

Itariki: ………………………………………………………
Kashe
Umukono: …………………………………………………

1 Bitewe n’imitungire y’ubutaka, ibyangombwa by’ubutaka bishobora kuba kimwe muri ibi bikurikira:
 Amasezerano y’ubukode burambye, icyemezo cy’iyandikisha ry’ubukode bw’igihe kirekire n’ igishushanyo cyerekana ingano y’ubutaka
 Icyemezo cy’inkondabutaka
 Icyemezo cy’Iyandikisha ry’Impapurompamo ngenankomyi,
 Icyemezo cy’iyandikisha ry’ibice by’isangiramutungo ku nyubako