REPUBLIC OF KENYA

IN THE MATTER OF THE OATHS AND STATUTORY DECLARATIONS

ACT, CAP 15 OF THE LAWS OF KENYA

AFFIDAVIT

I, JULIUS OBA of P.O. Box 123 Nairobi, do hereby make oath and state as follows:-

That I am a citizen of the Republic of Kenya and holder of Identity Card No.
1234567.

That I have since the 12th day of December 1999, embraced Islam as my religion of
faith and I hereby unequivocally renounce all other religions.

That I hold a Certificate of Confessing Islam to that effect.

That accordingly I have adopted the name JAMAL OBA to reflect my new religious
status as a Muslim.

That I swear this affidavit in declaration that I am now a Muslim and would like to be
referred to by the name JAMAL OBA.

That what is deponed herein is true to the best of my knowledge, information and
belief.

SWORN by the said JULIUS OBA now }

known as JAMAL OBA this ……….. day of} ………………………………….
………………………., 1999. } DEPONENT
}
BEFORE ME }
}
}
}
}
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COMMISSIONER FOR OATHS }