9/16/2020 The Nigeria Immigration Service

Standard ePassport (Renewal) Application Form

Important Information

Application Id: 16651602

Reference No: 1245938194

General Information
Title
MR

Last name (Surname)

KAFOR

First name
CHIJIOKE

Middle name

Gender
Male

Date of birth (dd-mm-yyyy)

05 10 1976

Passport Booklet Type

32 Pages

Validity Type
5 Years

National Identity Number (NIN)

--

Passport Number
A07637714

Place of birth
AMAKOHIA

Permanent Address (in Nigeria)

Address 1
ISINWEKE ROAD AMAKOHIA

Address 2

City
EKEREOCHA

Country
Nigeria

State
Imo

LGA
Ihitte/Uboma

District

Postcode

Contact Information

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State of Origin
Imo

Nationality
Nigeria

Home town
ISINWEKE

Contact phone
+60169563451

Email
simeony755@yahoo.com

Mobile phone
+60169563451

Occupation

Maiden name
Onwuzuruike

Personal Features
Marital status
Married

Color of eyes
Gray

Color of hair
Black

Height (in cm)

172

Other Information
Special Features
EYES

Next of kin name

CHIJIOKE OGOKE

Relationship with next of kin

BROTHER

Contact number of next of kin

+2348108442253

Kin Address
Address 1
AMUZU AMAKOHIA

Address 2

City
AMAKOHIA

Country
Nigeria

State
Imo

LGA
Ihitte/Uboma

District

Postcode

Passport Processing Country, State and Office

Processing Embassy
Kuala Lumpur

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Submission
Any false declaration on this form may lead to the withdrawal of the passport and/or prosecution of the applicant.

Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Signature / Thumb Impression: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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