IN THE MATTER OF THE STATUTORY DECLARATIONS ACT, 1971 (ACT 389)

AND

IN THE MATTER OF A STATUTORY DECLARATION BY EWURA ADWOA TAWIAH ANSAH

ATTESTING TO HER MISSING PASSPORT

I, Ewura Adwoa Tawiah Ansah of H/No AA 231,Abokobi, Accra do solemnly and sincerely
declare as follows:

1. That I am the declarant herein.

2. That I am a citizen of Ghana and a dentist by profession.

3. That I acquired a passport sometime around June, 2012 with passport number
G0333633.

4. That through no fault of mine my passport got lost in 2016 when I submitted same for
renewal.

5. That all efforts to find the passport have proven futile.

6. That it is my intention to obtain a new passport since I have not been able to retrieve my
old passport.

7. That I therefore submitted an application to acquire a new passport from the Ministry of
Foreign Affairs and Regional Integration.

8. That I was advised to report the issue to the police.

9. That I have reported the incident to the Agbogba police station and obtained a police
report on 14th February, 2024.

Wherefore I make this solemn declaration conscientiously believing it to be true, in accordance

with the Statutory Declarations Act, 1971 (Act 389).

DECLARED AT ACCRA THIS } ..…..……………………………………………

28TH DAY OF FEBRUARY, 2024 } DECLARANT

BEFORE ME

COMMISSIONER FOR OATHS