Republic of Uganda
Ministry of Internal A�airs
Directorate of Citizenship and Immigration Control
PASSPORT APPLICATION PAYMENT ADVICE FORM (PERSONAL COPY)
Print this form and make payments in the bank then return to the portal to schedule an appointment
APPLICATON DETAILS PASSPORT PHOTO
Application Number W003824706 PLEASE PASTE
Applicant Name eunice babirye DO NOT STAPLE
Date Of Birth July 7, 1997 THE PHOTO SHOULD BE
Telephone Number +256756310077 COLOURED WITH A WHITE
Email babiryeeunice@gmil.com BACKGROUND
NIN cf97083103ypnk
Signature
Type of Passport Ordinary
Type of Application New application
Priority Standard
Place of Submission Central O�ce Kampala
Place of Collection Central O�ce Kampala
PAYMENT DETAILS
Assessment Date 18/05/2025
Bank Name Equity Bank Uganda Limited
Description PRN Amount
Passport Ordinary (48 Pages) 2250014740732 250,000
TOTAL TO PAY 250,000
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PASSPORT APPLICATION PAYMENT ADVICE FORM (BANK COPY)
Print this form and make payments in the bank then return to the portal to schedule an appointment
APPLICATON DETAILS
Application Number W003824706
Applicant Name eunice babirye
Date Of Birth July 7, 1997
Telephone Number +256756310077
Email babiryeeunice@gmil.com
NIN cf97083103ypnk
Signature
Type of Passport Ordinary
Type of Application New application
Priority Standard
Place of Submission Central O�ce Kampala
Place of Collection Central O�ce Kampala
PAYMENT DETAILS
Assessment Date 18/05/2025
Bank Name Equity Bank Uganda Limited
Description PRN Amount
Passport Ordinary (48 Pages) 2250014740732 250,000
TOTAL TO PAY 250,000
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THE APPLICATION
Passport Type Ordinary
Type of Application New application
Priority Standard
Place of submission Central O�ce Kampala
Old Passport
Place of issue
Date of issue
Date of expiry
THE APPLICANT
Personal details
Surname babirye
Given name eunice
Maiden name
Other Names
Telephone Number +256756310077
National Identi�cation Number (NIN) cf97083103ypnk
Card No 00681278
Sex Male
Date Of Birth July 7, 1997
Marital Status Single
Place of Birth bugulusi
Profession/Occupation Other
Email babiryeeunice@gmil.com
Residential Address
Country of residence Uganda
District BUYENDE
County/Municipality BUDIOPE EAST COUNTY
Sub county BUGAYA
Parish/Ward BUSAABI
Village (LC1/Zone) BUGULUSI
Plot number
If out of Uganda state address
Details of origin
Nationality Uganda
District BUYENDE
County/Municipality BUDIOPE EAST COUNTY
Sub county BUGAYA
Parish/Ward BUSAABI
Village (LC1/Zone) BUGULUSI
Plot number
Applicant's tribe Basoga
Give details of clan/generation of origin nyange
First Descendant wakabi Ibrahim
Second Descendant banalekaki azalia
CITIZENSHIP
Citizenship By birth
Provide Dual certi�cate number
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Date of issue
Previous or other nationality
Other passport number
State date of renunciation of previous citizenship
SPOUSE
Spouse Surname
Spouse Given name
Maiden names
Date of marriage
Place of marriage
PARENTS DETAILS
Father's details
Father Status Alive
Father surname Bewala
Father given name james
National Identity Number (NIN) cm510831027h4f
Date of birth (DD/MM/YYYY) Sept. 21, 1951
Country of Birth Uganda
Place of Birth Bugulusi
Country of Residence Uganda
If out of Uganda state address
District BUYENDE
County/Municipality BUDIOPE EAST COUNTY
Sub county BUGAYA
Parish/Ward BUSAABI
Village (LC1/Zone) BUGULUSI
Plot number
Fathers's tribe Basoga
Nationality UGANDAN
Mother's details
Mother Status Alive
Mother surname nabirye
Mother given name Harriet
Mother maiden name nil
National Identity Number (NIN) Cf7208310050eg
Date of birth (DD/MM/YYYY) Feb. 22, 1972
Country of Birth Uganda
Place of Birth bugulusi
Country of Residence Uganda
If out of Uganda state address
District BUYENDE
County/Municipality BUDIOPE EAST COUNTY
Sub county BUGAYA
Parish/Ward BUSAABI
Village (LC1/Zone) BUGULUSI
Plot number
Mothers's tribe Basoga
Nationality UGANDAN
NEXT OF KIN
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Contact surname Wangobo
Contact given name Ali
Phone number +256755106353
Email wangoboali@gmail.com
District JINJA
County/Municipality BUTEMBE COUNTY
Sub county MAFUBIRA
Parish/Ward MAFUBIRA
Village (LC1/Zone) KYAMAGWA
Plot number
Relationship -- other --
Speci�c Relationship �ance
NIN cm82008104kphe
Passport number
Place of work (organization and physical address
If out of Uganda state address
RECOMMENDER
Recommender surname tindyebwa
Recommender given name gibson
Profession/Occupation Computer & Information Sciences
Other Occupation
Address Salaama rd
NIN Cm9805210alfhf
Phone +256755315181
Signature
ELSE RECOMMENDER
Recommender surname
Recommender given name
Profession/Occupation
Address
NIN
Phone
Signature
PAYMENT
Payment Mode Over-the-counter bank payment
Payment Bank Equity Bank Uganda Limited
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Note
You can pay all PRNs obtained using:
I. Mobile money
II. Cheque
III. Bank over the counter
IV. Point pf Sale
Other payment methods provided by your bank include
I. Electronic funds transfer
II. Real time gross settlement
III. Swift
IV. Online payment (VISA MasterCard, Union pay, American express with : Orient, STANBIC and Barclays Banks)
If you fail to complete the online transaction you can try again later with the online bank option or pay the same PRN
using any other payment option at acceptable banks.
You can use any of the following banks of their choice once you have a PRN
1. Bank Of Africa
2. Bank Of Baroda
3. Bank Of Uganda
4. Barclays Bank
5. Commercial Bank Of Africa Uganda Limited
6. Cairo International Bank
7. Centenary Bank
8. Citibank
9. DFCU Bank
10. Diamond Trust Bank
11. Eco Bank
12. Equity Bank Uganda Limited
13. Exim Bank Uganda Limited
14. Finance Trust Bank Limited
15. Gtbank
16. Housing Finance Bank
17. KCB Bank Uganda
18. NC Bank Uganda Limited
19. Orient Bank
20. Post Bank Uganda Limited
21. Pride Micro�nance Uganda Ltd
22. STANBIC
23. Standard Chartered
24. Tropical Bank Ltd
25. United Bank For Africa
NB: Please ensure to pay your PRN before 21 days expire
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