IFISHI 15.

b
V.05 Edition January 2023

ICYEMEZO GIHAMYA ABAZUNGURA MU GIHE NTA MAKIMBIRANE BAFITANYE

Nshingiye ku ngingo ya 73, 76, 84 na 85 z’Itegeko No 27/2016 ryo kuwa 08/07/2016 rigena Imicungire
y’umutungo w’abashyingiranwe, Impano n’izungura;

Maze kubona ko inama y’umuryango wa Nyakwigendera .......................................................................... na

...................................................................................(shyiraho ababyeyi bombi) yateranye ku
wa.................................................................., ikaba yari igizwe n'aba bakurikira:

Nº Amazina Nº y'ibimuranga Isano afitanye na ba Umukono

nyakwigendera
1 Uwapfakaye

2 Uhagarariye umuryango
w’umugabo (iyo yapfuye)
3 Uhagarariye umuryango
w’umugore (iyo yapfuye)
4 Inshuti y’umuryango
w’umugabo
5 Inshuti y’umuryango
w’umugore
6 Uhagarariye abazunggura
(Iyo hari abagejeje imyaka
y’ubukure)
ICYITONDERWA: Mu gihe hari icyiciro cy'abagize inama y’umuryango kidashobora kuboneka Umwanditsi w’irangamimirere
(Umunyamabanga nshingwabikorwa w'Umurenge) abikorera raporo ikomekwa kuri iyi nyandiko.

ikemezako ko abazungura babo ari aba bakurikira: (Shyiraho umugereka mu gihe abazungura barenga 10)

Nº Amazina Nº y'ibimuranga Isano afitanye na Umukono

ba nyakwigendera
1
2
3
4
5
6
7
8
9
10

Nshingiye ku byemezo by'uko ……...........……….......................................................... na.............................................................

bitabye Imana;

Nshingiye ku myanzuro y'inama y’umuryango wa ba nyakwigendera;

Mpamije ko abavuzwe haruguru aribo bazungura ba Nyakwigendera .............................................................. na
.........................................., nk’uko bemejwe n'inama y'umuryango. Uwo batoranyijwe kubahagararira
ni.......................................................................

Bikorewe i……………………………………….Ku wa .............../................../....................

Umunyamabanga Nshingwabikorwa akaba

n’Umwanditsi w’irangamimerere w'Umurenge wa ..............................................................

Amazina, .............................................................................................................

Umukono: ………………………………………………….

Kashi