Ministry of Foreign Affairs & Regional Integration

Republic of Ghana Passport Application

Application ID: 2465CB96BD2D1F9 Vetting Appointment Slip

Applicant's Name: Samuel Abbetey Niikum

Application Type: Standard Application 32 Pages
Application Date: Tue, 13 February 2024 Center: Premium PAC - Accra
Appointment Date: Tue, 25 June 2024 Reporting Time: 1:30PM
PAC Location: Accra Digital Center, Adjacent State Housing Company, Ring Road West, Accra Vetting Officer 1
You are subscribing to a premium PAC. Additional charges will apply.
You will need to bring the printout of your application data below and the original copy of
the following document(s)
Vetting Officer 2
Birth Certificate

Proof of Profession

Any National ID Vetting Officer 3

Witness Signature and Stamp:

Vetting Officer 4

Priscilla Bediako Asare Approving Officer

(Senior Civil / Public Servant)
Applicant's Signature:

OFFICIAL
COMMENTS:

Niikum Samuel Abbetey

DRESS CODE:
Appplicant's Dress Colour to the PAC should NOT be White
WARNING:
Making a statement which is, to your knowledge untrue for the purpose of procuring a
passport for yourself or any other person is an offence under Criminal Offences Act, 1960
(Act 29) and is liable on conviction to a fine not exceeding five hundred penalty units or to
a term of imprisonment not exceeding two years or both the fine and the imprisonment.
Such wilful false statements and the like may jeopardise the validity of the application or
submission or any use resulting therefrom.
For help call these numbers: 030 700 8222
:
 Applicant
Title: Mr

Surname: Niikum

First Name: Samuel

Other Name: Abbetey

Maiden Name -

Previous Names -

Gender Male

Date of Birth 23 October, 1989

City or town of Nsawam-Adoagyiri

birth

Country of Birth Ghana

Height 1.66 m National ID GHA-721328005-4

Colour of eyes BROWN Social Security -

Colour of hair BLACK Voter ID -

Visible -
Perculiarities Telephone 0557745990
Number

Nationality Ghanaian Email Address nannahepheyahasamoah@gmail.com

Dual Citizenship -
House Number Doboro 117
Marital Status Single
Street Name Doboro-Blueskies
Profession Contractor
Postal Address GW-1066-6108
Previous Contractor
Profession
Suburb Eastern Region

Mandatory Document to Present Birth Certificate City of Nsawam

Residence
Document Number 03230139182023
Country of Ghana (0000)
Date of Issue 3 August, 2023 Residence (Zip /
Post Code)
Place of Issue Nsawam-Adoagyiri

Education
The Applicant has not received any form of formal education.
:
 Citizenship
Relationship Father Relationship Mother

Full Name Samuel Abbetey Full Name Comfort Baah Lantua

Living Yes Living Yes

Telephone 0557745990 Telephone 0243667755

Email - Email -

HomeTown Ha Asoaba HomeTown Asuoba

Residential Ha Asoaba Residential Ga Asaba

Address Address

Postal Address Oduman Asoaba Postal Address GW-1066-6108

Nationality Ghanaian Nationality Ghanaian

Relationship Grand Parent

Full Name Auntie Ama

Living No

Telephone -

Email -

HomeTown Ga Asuaba

Residential Ga Asuaba
Address

Postal Address GW-1066-6108

Nationality Ghanaian

Guarantors
First Guarantor Second Guarantor

Full Name Joseph Nii Kumi Full Name Daniel Nii Kumi

Occupation Contractor Occupation Tiller/Plumber

Telephone 0547333933 Telephone 0547826063

Email 0552242620josephkumi@gmail.com Email -

Residential Dansoman Residential Doboro, Blueskies

Address Address
:
 Witness
Full Name Priscilla Bediako Asare Occupation Executive Secretary

Business 0552540175 Position Senior Civil / Public Servant

Telephone
Card NATIDC
Residential 0536908270
Telephone Card Number GHA-002191022-1

Business Yotek Enterprise Limited, Accra Date of Issue 2022-01-21

Address
Place of Issue Accra
Residential P.O Box 16505 KIA-Accra
Address

Support Lines:
Premium PAC Enquiries - 0302214944
General Information - 0307000575 / 0307008222 / 0302738473
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