Republic of Uganda

Ministry of Internal A�airs

Directorate of Citizenship and Immigration Control

PASSPORT APPLICATION PAYMENT ADVICE FORM (PERSONAL COPY)

Print this form and make payments in the bank then return to the portal to schedule an appointment

APPLICATON DETAILS PASSPORT PHOTO

Application Number W001649240 PLEASE PASTE
Applicant Name BABIRYE HADIJA NAKIDALI DO NOT STAPLE
Date Of Birth Aug. 28, 1999 THE PHOTO SHOULD BE
Telephone Number +256703470405 COLOURED WITH A WHITE
Email BACKGROUND
NIN

Signature

Type of Passport Ordinary

Type of Application New application
Priority Express
Place of Submission Central O�ce Kampala
Place of Collection Central O�ce Kampala
PAYMENT DETAILS
Assessment Date 14/06/2022
Bank Name Diamond Trust Bank

Description PRN Amount

Passport Ordinary (48 Pages) 2220010177832 250,000

Fee For Express Processing Of Passport 2220010177834 150,000

TOTAL TO PAY 400,000

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 PASSPORT APPLICATION PAYMENT ADVICE FORM (BANK COPY)
Print this form and make payments in the bank then return to the portal to schedule an appointment

APPLICATON DETAILS
Application Number W001649240
Applicant Name BABIRYE HADIJA NAKIDALI
Date Of Birth Aug. 28, 1999
Telephone Number +256703470405
Email
NIN

Signature

Type of Passport Ordinary

Type of Application New application
Priority Express
Place of Submission Central O�ce Kampala
Place of Collection Central O�ce Kampala
PAYMENT DETAILS
Assessment Date 14/06/2022
Bank Name Diamond Trust Bank

Description PRN Amount

Passport Ordinary (48 Pages) 2220010177832 250,000

Fee For Express Processing Of Passport 2220010177834 150,000

TOTAL TO PAY 400,000

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THE APPLICATION
Passport Type Ordinary
Type of Application New application
Priority Express
Place of submission Central O�ce Kampala
Old Passport
Place of issue
Date of issue
Date of expiry
THE APPLICANT
Personal details
Surname NAKIDALI
Given name BABIRYE HADIJA
Maiden name
Other Names
Telephone Number +256703470405
National Identi�cation Number (NIN)
Card No
Sex Female
Date Of Birth Aug. 28, 1999
Marital Status Single
Place of Birth KAMPALA
Profession/Occupation
Email
Residential Address
Country of residence Uganda
District KAMPALA
County/Municipality KAWEMPE DIVISION NORTH
Sub county KAWEMPE DIVISION
Parish/Ward KAWEMPE I
Village (LC1/Zone) MBOGO
Plot number
If out of Uganda state address
Details of origin
Nationality Uganda
District KAMPALA
County/Municipality KAWEMPE DIVISION NORTH
Sub county KAWEMPE DIVISION
Parish/Ward KAWEMPE I
Village (LC1/Zone) MBOGO
Plot number
Applicant's tribe Baganda
Give details of clan/generation of origin
First Descendant
Second Descendant
CITIZENSHIP
Citizenship By birth
Provide Dual certi�cate number

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Date of issue
Previous or other nationality
Other passport number
State date of renunciation of previous citizenship
SPOUSE
Spouse Surname
Spouse Given name
Maiden names
Date of marriage
Place of marriage
PARENTS DETAILS
Father's details
Father Status Alive
Father surname SSEKALEGA
Father given name YAHYA
National Identity Number (NIN)
Date of birth (DD/MM/YYYY) Sept. 17, 1960
Country of Birth Uganda
Place of Birth MPIGI
Country of Residence Uganda
If out of Uganda state address
District KAMPALA
County/Municipality KAWEMPE DIVISION NORTH
Sub county KAWEMPE DIVISION
Parish/Ward KAWEMPE I
Village (LC1/Zone) MBOGO
Plot number
Fathers's tribe Baganda
Nationality UGANDAN
Mother's details
Mother Status Alive
Mother surname NASSAKA
Mother given name FATUMA
Mother maiden name SSEKALEGA
National Identity Number (NIN)
Date of birth (DD/MM/YYYY) Jan. 1, 1964
Country of Birth Uganda
Place of Birth KAWEMPE
Country of Residence Uganda
If out of Uganda state address
District KAMPALA
County/Municipality KAWEMPE DIVISION NORTH
Sub county KAWEMPE DIVISION
Parish/Ward KAWEMPE I
Village (LC1/Zone) MBOGO
Plot number
Mothers's tribe Baganda
Nationality UGANDAN
NEXT OF KIN

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Contact surname KAGIMU
Contact given name HADAD KAWOOYA
Phone number +256703470405
Email
District WAKISO
County/Municipality BUSIRO COUNTY SOUTH
Sub county KASANJE
Parish/Ward JUNGO
Village (LC1/Zone) BUWOOYA/KIWUMU
Plot number
Relationship -- other --
Speci�c Relationship UNCLE
NIN CM801051033VJE
Passport number
Place of work (organization and physical address
If out of Uganda state address
RECOMMENDER
Recommender surname KALITWE
Recommender given name ABDU
Profession/Occupation Education
Other Occupation
Address EAST HIGH SCHOOL NTINDA
NIN CM92091104A0WF
Phone +256703144633

Signature

ELSE RECOMMENDER
Recommender surname
Recommender given name
Profession/Occupation
Address
NIN
Phone

Signature

PAYMENT
Payment Mode Over-the-counter bank payment
Payment Bank Diamond Trust Bank

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Note

You can pay all PRNs obtained using:

I. Mobile money
II. Cheque
III. Bank over the counter
IV. Point pf Sale

Other payment methods provided by your bank include

I. Electronic funds transfer
II. Real time gross settlement
III. Swift
IV. Online payment (VISA MasterCard, Union pay, American express with : Orient, STANBIC and Barclays Banks)
If you fail to complete the online transaction you can try again later with the online bank option or pay the same PRN
using any other payment option at acceptable banks.

You can use any of the following banks of their choice once you have a PRN
1. Bank Of Africa
2. Bank Of Baroda
3. Bank Of Uganda
4. Barclays Bank
5. Commercial Bank Of Africa Uganda Limited
6. Cairo International Bank
7. Centenary Bank
8. Citibank
9. DFCU Bank
10. Diamond Trust Bank
11. Eco Bank
12. Equity Bank Uganda Limited
13. Exim Bank Uganda Limited
14. Finance Trust Bank Limited
15. Gtbank
16. Housing Finance Bank
17. KCB Bank Uganda
18. NC Bank Uganda Limited
19. Orient Bank
20. Post Bank Uganda Limited
21. Pride Micro�nance Uganda Ltd
22. STANBIC
23. Standard Chartered
24. Tropical Bank Ltd
25. United Bank For Africa

NB: Please ensure to pay your PRN before 21 days expire

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