(A) Application Form For Change of Land Use - Kinya

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V.05 Edition January 2023 IFISHI 4.

IFISHI ISABA GUHUZA IMIKORESHEREZE Y’UBUTAKA N’IGISHUSHANYO


MBONERA

Umwirondoro
Njyewe/Twebwe: .....…………………………………………………………………………………………………………………...........
Indangamuntu/Pasiporo: …………………..………………………………………………………………………………………..........
Aderesi: Akarere ka…………………….…. Umurenge wa ……………………………Akagari ka ……………………............
Umudugudu wa ………………................
Telefoni : ………………………………………... E-mail: ……................…………………………………………………………….........

Ndasaba guhindura guhindura imikoreshereze y’ubutaka

Amakuru ku kibanza/Isambu
Nimero y'ikibanza/isambu (UPI): …………………………..................................
Umujyi wa Kigali/Intara: ………………………………………................
Akarere: …………………………………………………...
Umurenge: …………………………………….……………..
Akagari: …………………………………….……………..

Ibisobanuro k'ubusabe………………………………………………………………………………………….....................................
……………………………………………………………………………………………………………………………….....................................
……………………………………………………………………………………………………………………………….....................................

Ibisabwa

Ibyangombwa by'ubutaka busabirwa guhindurirwa imikoreshereze1

…………………………….. ………………………………………………………………………………
Itariki y'ubusabe Umukono w'usaba (w'abasaba)

Byakiriwe kandi bisuzumwa na: ……………………………….............................................................

Icyo ashinzwe: ...........................................................................................

Itariki: ………………………………………………………
Kashe
Umukono: …………………………………………………

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Ibi bireba ibyangombwa byatanzwe mbere y’itariki ya 9 Mutarama 2023.

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