Savings and transitional

(1) A Belize passport issued prior to the commencement of these Regulations shall continue to be valid until the date on which that passport would otherwise expire or until that passport is recalled or cancelled. (2) An application for a Belize passport which was submitted prior to the commencement of these Regulations and which has not been dealt with prior to the commencement of these Regulations shall be dealt with as if these Regulations had not come into force. 15 SCHEDULE 11 FORM 1 Regulation 3(1)(a) BELIZE PASSPORT APPLICATION FOR PERSONS 16 YEARS AND OVER Please read the instructions overleaf before completing form. Section 1. Applicant Information Surname/Family name First & Middle names Date of Birth _____/______/_______ (day/month/year) Place of Birth (city & country) Gender: Male: ☐ Female: ☐ Marital Status: Single:☐ Married☐ Divorced☐Widowed ☐ Maiden name (of married women) Has name been changed (other than by marriage, e.g., deed poll)? If so, state original name. Home address Phone no. If home address is not in Belize, address whilst in Belize Phone no. Occupation Residence (country) Height Feet: Inches: Colour of eyes Colour of hair Distinguishing marks/ Special peculiarities 1 This Schedule was repealed and replaced by S.I. No. 6 of 2020. 16 Passports Section 2. Married women (including divorcee and widows) are to complete this section. Full name of husband Husband’s nationality Husband’s date of Birth (day/month/year) _______/_________/_______ Husband’s place of birth Place of marriage Date of marriage Section 3. Citizens of Belize by naturalization are to complete this section. Number of nationality document Date of issue of nationality document Place of issue of nationality document Passports 17 Section 4. Declaration (Please tick all those that apply) I, the undersigned, hereby apply for the issue of a Belize passport, I declare that: ☐ (A) The information given here is correct to the best of my knowledge and belief; ☐ (B) I have not lost the status of citizen of Belize; From the below, please choose that which is applicable. ☐ (C) I have not previously held or applied for a Belize passport. ☐ (D) Attached is passport number ______________ issued at _________________ on ____/____/_____ (day/month/year). I have not made another application for a Belize passport since it was issued and I have surrendered all previous passports; ☐ (E) Unavailable for presentation passport number _________________ issued at ___________________ on ______/______/______(day/month/year). I have attached a statutory declaration attesting to its loss, destruction or being stolen. Signature (within but not touching edges of box) Date _____/______/_______ Day / month / year 18 Passports Section 5. Authentication of Application Authentication of Application The application form must be authenticated and sponsored in Section 5 by one recommender; the recommender should fill FORM 3. FORM 3 must be filled by a recommender who is a Belizean national, whether by birth or descent. The recommender must be eighteen (18) years of age and over and in possession of a valid Belize Passport. Recommender must be acquainted with the applicant for at least one year. WARNING TO the applicant and the recommenderIt is a prosecutable offence [pursuant to Section 3(e) and (h) of the Passports Act, Chapter 164, Laws of Belize] to make any false representation with respect to information requested by this form. Passports 19 FOR OFFICIAL USE ONLY Form accepted by_________________ Date ____/_____/___ (day/month/yea r) NEW PASSPORT NUMBER____________________________ Document Submitted Applicant’s Applicant’s Applicant’s Marriage Certificate Social Security/ Voters ID Other Documents Birth Certificate Previous Passport Nationality Certificate e.g., Deed Poll No.: No.: No.: No.: No.: District: Place of Issue: Place of Issue: Place of Issue: Date of Issue: Date of Issue: Date of Issue: Date of Issue: Date of Issue: Date of Registration Cashier__________________ RCR Date ___/___/___ RCR No.:_________________ Amount: $________________ Counter Supervisor _________ Data Entry _____________ OIC Approval ___________ Print Operator _____________ QA______________________ Passport Delivered by (Signature)__________________________ (Print Name)_________________________ Passport Received by (Signature)_________________________ (Print Name)_______________ Date ___/_____/___ (day/month/year) 20 Passports BELIZE PASSPORT APPLICATION INSTRUCTIONS 1. THIS FORM SHOULD BE CLEARLY WRITTEN IN PRINT WITH BLACK OR BLUE INK. 2. SECTIONS 1 AND 4 OF THIS FORM MUST BE COMPLETED BY ALL APPLICANTS. 3. SECTIONS 2 AND 3 MUST BE COMPLETED BY THOSE TO WHOM THEY APPLY. 4. THE OFFICIAL LANGUAGE IS ENGLISH AND ALL DOCUMENTS SUBMITTED MUST EITHER BE IN ENGLISH OR BE ACCOMPANIED BY A CERTIFIED ENGLISH TRANSLATION OF THAT DOCUMENT. Authentication of Application The application form must be authenticated and sponsored in FORM 3 by a recommender who is a Belizean national, whether by birth or descent. The recommender must be eighteen (18) years of age and over and in possession of a valid Belize Passport. Documents to be Produced If the applicant is: A. a Belizean by birth (born in Belize)– birth certificate from the Vital Statistics Unit (for those applying for the first time and those replacing lost, stolen or mutilated passports). B. a Belizean by descent born outside Belize to Belizean parent(s) but naturalized – (i) passport from native country and (ii) his/her naturalization by descent document or other evidence of Belizean nationality. C. a Belizean by registration (born outside Belize but has become a citizen through naturalization)– (i) native birth certificate or passport and (ii) his/her Belize nationality certificate. D. a married woman– all of the above that apply plus a marriage certificate (issued by vital statistics or Registrar’s office.) E. A divorced woman wishing to revert to her maiden name– all of the above that apply plus the divorce certificate. F. a Belizean renewing/replacing an available passport– previous passport and any other document(s) required by the Director of Nationality and Passports Department or an authorised officer. Passports 21 G. Valid identification documents is required from all. This may be in the form of social security cards, voter registration cards, passport from any country or naturalization certificate. H Two recent photographs– the recommender is to certify a photograph with the following quote, [“I certify that this is a true [image/picture/likeness] of [insert name of applicant or child”], signed by recommender. Photo Specifications: Taken within 6 months from application, white background and must be of 2 inches by 2 inches in size. A photocopy of all original documents must be submitted including a copy of the biographic data page of previous passport being renewed/ replaced. *For the applicant whose previous passport is now unavailable for submission (be it lost, stolen or mutilated), that applicant shall submit– (a) if lost, stolen or mutilated in Belize, the statutory declaration in Form 6 detailing the incident leading to the unavailability of the passport that is certified by a Justice of the Peace, Commissioner of Affidavit or Notary Public, along with a report from the Police indicating that the incident leading to the unavailability has been recorded; or (b) if lost, stolen or mutilated outside of Belize, the statutory declaration in Form 6 that is notarized by a Notary Public detailing the incident leading to the unavailability of the passport. The statutory declaration is also a requirement for those whose passport is available for presentation but has become damaged. A change of name other than by marriage must be substantiated by the production of evidence showing that a bona fide/legal change has been made for all purposes. For Belizeans applying abroad at a Belize Foreign Mission In the case of a person applying abroad at a Belizean Embassy, High Commission, Consulate or Consular Agency, authentication must be by ai.) Registered Medical Practitioner, ii.) Registered Legal Practitioner or iii.) Registered Minister of Religion; and must be accompanied by sworn and notarized affidavit signed by the same person certifying the photographs as per H above. The chargea. for an ordinary passport (48 pages)– $50.00 for a person of or above the age of 16 years and $30.00 for a person below the age of 16 years; 22 Passports b. to replace a lost, damaged, or stolen passport– $85.00 for a person of or above the age of 16 years and $55.00 for a person below the age of 16 years; c. for an emergency passport (within five (5) working days)– $100.00 for a person of or above the age of 16 years and $60.00 for a person below the age of 16 years; or d. expedited passports (In addition to fees applied in a or b)i. 24 Hours Service – $200.00 ii. 48 Hours Service – $100.00 iii. 3-5 Days Service – $50.00 Passports for persons of or above the age of 16 years are valid for ten years and passports for persons below the age of 16 years are valid for five years. In the case of persons applying abroad, fees and processing time are determined by the Foreign Mission. All fees are payable in cash. What to do with the completed form. The completed form with all necessary documents and fee must be presented personally at the Immigration and Nationality Headquarters, Belmopan, Passport section of the Immigration Office, Belize City, the Immigration Offices in the district towns of Corozal, Orange Walk, San Pedro, Dangriga, and Punta Gorda or at the Belize Foreign Mission in Los Angeles, Chicago, New York, Washington D.C., U.S.A., London, U.K., Taipei, Taiwan. Application forms may be obtained from any of these offices. Passports 23 FORM 2 [Regulation 3 (1) (b)] BELIZE PASSPORT APPLICATION FOR PERSONS BELOW THE AGE OF 16 YEARS Please read the instructions overleaf before completing form. Section 1. Child Information Surname/Family name First & Middle names Date of Birth ______/______/_______ (day /month / year Place of Birth (city & country) Has name been changed (e.g., deed poll)? If so, state original name. Gender: Male:☐ Female:☐ Home address Phone no. If home address is not in Belize, address whilst in Belize Phone no. Occupation Residence (country) Height Feet: Inches: Colour of eyes Colour of hair Distinguishing marks/ Special peculiarities 24 Passports Section 2. Applicant’s (Parent) Information Parent: Father:☐ Mother: ☐ Legal Guardian:☐ Full Names of Child’s Parent Mother: ____________________________ Father: ___________________________ Legal Guardian: ___________________________ Dates of Birth (day/month/year): ______/_______/______ ______/_______/______ ______/______/_______ Applicant’s Place of Birth Applicant’s Nationality Marital Status of Parents: Single:☐ Married☐ Divorce☐ Widowed ☐ Section 3. Citizens of Belize by naturalization are to complete this section. Number of nationality document Date of Issue of nationality document Place of issue of nationality document Passports 25 Section 4. Declaration (Please tick all those that apply) I, the undersigned, herby apply for the issue of a Belize passport, I declare that: ☐ (A) The information given here is correct to the best of my knowledge and belief; ☐ (B) I have not lost the status of citizen of Belize; From the below, please choose that which is applicable. ☐ (C) I have not previously held or applied for a Belize passport. ☐ (D) Attached is passport number _______________ issued at _________________ on _____/_____/_____ (day/month/year). I have not made another application for a Belize passport since it was issued and I have surrendered all previous passports; ☐ (E) Unavailable for presentation passport number _______________ issued at ______________ on _____/_____/_____ (day/month/year). I have attached a statutory declaration attesting to its loss, destruction or being stolen. Signature of Parent Date _____/______/____ day/ month / year Signature of Child (sign within but not touching box) Date ____/______/____ day/ month / year 26 Passports Section 5. Authentication of Application Authentication of Application The application form must be authenticated and sponsored in Section 5 by one recommender; the recommender should fill in FORM 4. FORM 4 must be filled by a recommender who is a Belizean national, whether by birth or descent. The recommender must be eighteen (18) years of age and over and in possession of a valid Belize Passport. Recommender must be acquainted with the applicant for at least one year. Warning To the applicant and the recommenderIt is a prosecutable offence [pursuant to Sections 3 (e) and (h) of the Passports Act, Chapter 164, Laws of Belize] to make any false representation with respect to information requested by this form. Passports 27 FOR OFFICIAL USE ONLY Form accepted by_________________ Date ____/_____/___ (day/month/year) NEW PASSPORT NUMBER____________________________ Document Submitted Applicant’s Other Documents e.g., Deed Poll No.: No.: No.: No.: No.: District: Place of Issue: Place of Issue: Place of Issue: Date of Issue: Date of Issue: Date of Issue: Date of Issue: Date of Issue: Date of Registration Applicant’s Applicant’s Marriage Certificate Social Security/ Voters ID Birth Certificate Previous Passport Nationality Certificate Cashier__________________ RCR Date ___/___/___ RCR No.:_________________ Amount: $________________ Counter Supervisor _________ Data Entry ______________ OIC Approval ____________ Print Operator _____________ QA______________________ Passport Delivered by (Signature)___________________________ (Print Name)_________________________ Passport Received by (Signature)_________________________ (Print Name)_______________ Date ___/_____/___ (day/month/year) 28 Passports BELIZE PASSPORT APPLICATION INSTRUCTIONS 1. THIS FORM SHOULD BE CLEARLY WRITTEN IN PRINT WITH BLACK OR BLUE INK. 2. SECTIONS 1, 2 AND 4 OF THIS FORM MUST BE COMPLETED BY ALL APPLICANTS. 3. SECTIONS 3 MUST BE COMPLETED BY THOSE TO WHOM THEY APPLY. 4. THE OFFICIAL LANGUAGE IS ENGLISH AND ALL DOCUMENTS SUBMITTED MUST EITHER BE IN ENGLISH OR BE ACCOMPANIED BY A CERTIFIED ENGLISH TRANSLATION OF THAT DOCUMENT. The application for a Belize passport shall be signed by– (a) the applicant; and (b) the child, where the application is in respect of a child who is ten years or older. Authentication of Application The application form must be authenticated and sponsored in FORM 4 by a recommender who is a Belizean national, whether by birth or descent. The recommender must be eighteen (18) years of age and over and in possession of a valid Belize Passport. Documents to be Produced If the applicant is: A. a Belizean by birth (born in Belize)– birth certificate from the Vital Statistics Unit (for those applying for the first time and those replacing lost, stolen or mutilated passports). B. a Belizean by descent (born outside Belize to Belizean parent(s) but naturalized)– (i) passport from native country and (ii) his/her naturalization by descent document or other evidence of Belizean nationality. C. a Belizean by registration (born outside Belize but has become a citizen through naturalization)– (i) native birth certificate or passport and (ii) his/her Belize nationality certificate. D. a Belizean renewing/replacing an available passport– previous passport and any other document(s) required by the Director of Nationality and Passports Department or an authorised officer. Passports 29 E. Valid identification documents is required from all. This may be in the form of social security cards, voter registration cards, passport from any country or naturalization certificate. F. Two recent photographs– the recommender is to certify a photograph with the following quote, [“I certify that this is a true [image/picture/likeness] of [insert name of applicant or child”], signed by recommender. Photo Specifications: Taken within 6 months from application, white background and must be of 2 inches by 2 inches in size. A photocopy of all original documents must be submitted including a copy of the biographic data page of previous passport being renewed/ replaced. *For the applicant whose previous passport is unavailable for submission (be it lost, stolen or mutilated), that applicant shall submit– (a) if lost, stolen or mutilated in Belize, the statutory declaration in Form 6 detailing the incident leading to the unavailability of the passport that is certified by a Justice of the Peace, Commissioner of Affidavit or Notary Public, along with a report from the Police indicating that the incident leading to the unavailability has been recorded; or (b) if lost, stolen or mutilated outside of Belize, the statutory declaration in Form 6 that is notarized by a Notary Public detailing the incident leading to the unavailability of the passport. The statutory declaration is also a requirement for those whose passport is available for presentation but has become damaged. A change of name other than by marriage must be substantiated by the production of evidence showing that a bona fide/legal change has been made for all purposes. For Belizeans applying abroad at a Belize Foreign Mission In the case of a person applying abroad at a Belizean Embassy, High Commission, Consulate or Consular Agency, authentication must be by ai.) Registered Medical Practitioner, ii.) Registered Legal Practitioner or iii.) Registered Minister of Religion; and must be accompanied by sworn and notarized affidavit signed by the same person certifying the photographs as per F above. The charge30 Passports a. for an ordinary passport (48 pages)– $50.00 for a person of or above the age of 16 years and $30.00 for a person below the age of 16 years; b. to replace a lost, damaged, or stolen passport– $85.00 for a person of or above the age of 16 years and $55.00 for a person below the age of 16 years; c. for an emergency passport (within five (5) working days– $100.00 for a person of or above the age of 16 years and $60.00 for a person below the age of 16 years; or d. expedited passports (In addition to fees applied in a or b)i. 24 Hours Service – $200.00 ii. 48 Hours Service – $100.00 iii. 3-5 Days Service – $50.00 Passports for persons of or above the age of 16 years are valid for ten years and passports for persons below the age of 16 years are valid for five years. In the case of persons applying abroad, fees and processing time are determined by the Foreign Mission. All fees are payable in cash. What to do with the completed form. The completed form with all necessary documents and fee must be presented personally at the Immigration and Nationality Headquarters, Belmopan, Passport section of the Immigration Office, Belize City, the Immigration Offices in the district towns of Corozal, Orange Walk, San Pedro, Dangriga, and Punta Gorda or at the Belize Foreign Mission in Los Angeles, Chicago, New York, Washington D.C., U.S.A., London, U.K., Taipei, Taiwan. Application forms may be obtained from any of these offices. Passports 31 FORM 3 Regulation 7(1) DECLARATION OF RECOMMENDER FOR BELIZE PASSPORT APPLICATION FOR PERSONS 16 YEARS AND OVER I, (Mr., Mrs., Miss) ______________________________________ of [print full name of Recommender] _______________________________________________ and currently [insert full address] employed as ___________________________ hereby declare/certify that I am a [state profession or if retired] Belizean by ________________and I have been personally acquainted with the [birth or descent] Applicant (Mr., Mrs., Miss) ______________________ for the past ________ years [print full name of applicant] [number of years] through _______________________________ and that the information provided in [specify relationship] his/her Belize passport application, with respect to identity, is true and correct to the best of my knowledge, information and belief. I understand that it is an offence under section 3(e) and (h) of the Passports Act, Chapter 164 of the Laws of Belize, to make any false representation with respect to information requested by this form. Signature of Recommender: _____________________________ Date:_______/________/_______ [ day / month / year] Tel: Office/Work: _____________________ Mobile: __________________________ Email: ______________________ Recommender’s Passport Number: ___________________ Date of issue: ___/__/___ Documents to be Produced (a) Copy of machine readable Belize passport; and (b) Signed oath of accuracy on the application. 32 Passports Form 4 [Regulations 7(2)] DECLARATION OF RECOMMENDER FOR BELIZE PASSPORT APPLICATION FOR CHILD/MINOR (PERSONS UNDER 16 YEARS) I, (Mr., Mrs., Miss) _______________________________ of ____________________ [print full name of recommender] [insert full address] _______________________________ and currently employed as ________________ [state profession or if retired] hereby declare/certify that I have been personally acquainted with the child (Mr., Miss) __________________________ for the past _________ years through [print full name of child] [number of years] ______________________, and that the said (Mr, Mrs., Miss) ___________________ [specify relationship] [print full name of parent] is the parent of the child (Mr,. Miss) _______________________; and that the [print full name of child] information provided in his/her Belize passport application, with respect to identity, is true and correct to the best of my knowledge, information and belief. I understand that it is an offence under section 3(e) and (h) of the Passports Act, Chapter 164 of the Laws of Belize, to make any false representation with respect to Information requested by this form. Signature of Recommender: ___________________ Date: ___/___/___ Tel: Office/Work: __________________ Mobile: ________________________ Email: ____________________ Recommender’s Passport Number:_________________ Date of Issue: ___/___/___ Documents to be Produced (a) Copy of machine readable Belize passport; and (b) signed oath of accuracy on the application. Passports 33 FORM 5 [Regulation 7(3)] DECLARATION OF APPLICANT FOR PERSONS SUBMITTING APPLICATIONS TO BELIZE FOREIGN MISSION I, _______________________ of ________________________________ [insert full name] [insert full address] Hereby declare that– (a) the information provided in my application for a Belize passport for [myself/the child] ____________________ dated ___________________ [insert child’s name if applicable [ insert date of application] is true and correct to the best of my knowledge, information and belief; (b) I am a citizen of Belize and have not renounced or lost my status as a citizen of Belize; (c) I have/the above-named child has[indicate and complete the applicable option below] ☐ not previously held or applied for a Belize passport. ☐ previously held passport number__________ issued at ____________________ on the ____/_____/___. [day/ month /year] I have enclosed the said passport with the above mentioned application; I have not made another application for a Belize passport since the said Belize passport was issued and all previous passports to the said Belize passport have been surrendered. I have attached a Declaration of lost, stolen or mutilated Belize Passport in respect of the said Belize Passport to my application. Signature of Declarant ____________________ Date________________ Certification by Notary Public Made and subscribed this _____ day of __________ in the year __________. Before me, Name: _______________ Signature: ____________________ Official Title: ____________________ 34 Passports FORM 6 [Regulation 7(4)] DECLARATION OF LOST, STOLEN OR MUTILATED BELIZE PASSPORT WARNING TO ALL APPLICANTS Any person who makes a written or oral statement knowingly to be false or misleading is guilty of FOR OFFICIAL USE ONLY an offense and is liable to a fine and imprisonment. PASSPORT CONTROL PLEASE PRINT INFORMATION IN BLOCK LETTERS USING DARK BLUE OR OFFICER ________________ ________________ ________________ ________________ BLACK INK PEN THIS FORM IS TO BE FILLED OUT BY THE APPLICANT & SHOULD BE SIGNED IN THE PRESENCE OF THE COMMISSIONER OF AFFIDAVITS, JUSTICE OF THE PEACE OR NOTARY PUBLIC. This is to report the loss, theft or mutilation of a Belize passport IMPORTANT– completing this form will not provide you with a replacement passport to replace your lost, stolen or mutilated passport, you will need to submit this form, one passport size photograph, a passport application form, supporting documents and fee. 1. DETAILS OF THE LOST, STOLEN OR MUTILATED PASSPORT NAME IN WHICH THE PASSPORT WAS ISSUED SURNAME /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ FIRST NAME /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ MIDDLE NAME(S) /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ DATE OF BIRTH /__/__/ /__/__/__/ /__/__/__/__/ Date Month Year TOWN/CITY OF BIRTH /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ COUNTRY OF BIRTH /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ PASSPORT NO. /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ DATE OF ISSUE /__/__/ /__/__/__/ /__/__/__/__/ Day Month Year ISSUE OFFICE /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ STATUS OF PASSPORT LOST STOLEN MUTILATED Passports 35 2. CURRENT DETAILS (TO BE FILLED ONLY IF DIFFERENT FROM SECTION 1) CURRENT SURNAME /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ CURRENT FIRST NAME /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ MIDDLE NAME(S) /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ 3. CURRENT HOME ADDRESS /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ HOME TEL. NO. /__/__/__/__/__/__/__/__/__/ E-MAIL ADDRESS ____________________ MOBILE NO. /__/__/__/__/__/__/__/__/__/__/ 4. POLICE REPORT (for passports lost, stolen or mutilated in Belize) HAS THE LOSS, THEFT OF THE PASSPORT BEEN REPORTED TO THE POLICE? YES NO DATE REPORTED TO POLICE __/__ __/__/__ __/__/__/__ Day Month Year POLICE STATION /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ AND ADDRESS /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/ DETAIL HOW, WHEN OR WHERE THE LOSS, THEFT OR MUTILATION OF THE PASSPORT OCCURRED. 5. DECLARATION (for passports lost, stolen or mutilated outside the country) [detailing the incident leading to the unavailability of the passport, how, when, or where the loss, theft or mutilation of the passport occurred] to be notarized by a Notary Public. 6. HAVE YOU HAD ANY OTHER BELIZE PASSPORT LOST, STOLEN OR MUTILATED? YES NO 36 Passports 7. STATE THE COUNTRIES FOR WHICH YOU HAD VISAS ENDORSED IN THE PASSPORTS. I the undersigned certify that the information provided herein is correct and that I have not sold, pledge or otherwise given my passport to another person or disposed of it in an unauthorized manner. I understand that upon submission of this form, the related passport would be invalidated and can no longer be used. If the passport is subsequently found or recovered. I will immediately return same to the nearest Passport Office or Belize Foreign Mission Dated __/__ __/__/__ __/__/__/__ ________________ Day Month Year Signature of Applicant CERTIFICATION BY THE COMMISSIONER OF AFFIDAVITS, JUSTICE OF THE PEACE OR NOTARY PUBLIC For passports lost, stolen or mutilated in Belize– certification by a Commissioner of Affidavits or a Justice of the Peace. For passports lost, stolen or mutilated outside the country– certification by a Notary Public. Made and subscribed this ___________ day of __________ in the year ____________ Before me _______________________ ______________________ Name in Block Letters Signature ________________________ Official Title. MADE this 31st day of December, 2019. (HON.GODWIN HULSE) (Minister of Agriculture, Forestry, Fisheries, the Environment and Sustainable Development and Immigration (Minister responsible for Immigration) Passports 37 SCHEDULE 2 [Regulation 8] FEES FOR PASSPORT SERVICES Column 1 Passport Services Column 2 Fees BZ$ 1. Application for an Ordinary Passport (48 pages)to a person 16 years of age or older 50.00 to a person below 16 years of age 30.00 2. Application for a Passport (where previous passport, lost, damaged or stolen)to a person 16 years of age or older 85.00 to a person below 16 years of age 55.00 3.Application for a Passport in cases of Medical Emergency (to be issued within 5 working days ) to a person 16 years of age or older 100.00 to a person below 16 years of age 60.00 4.Expedited Passport Service (in addition to the fee applicable for the service listed as items 1 and 2 above) For expedition of passport within 24 hours 200.00 For expedition of passport within 48 hours 100.00 For expedition of passport within 3 to 5 working days 50.00 MADE by the Minister Responsible for Passports this 17th day of January, 2013. GODWIN HULSE Minister responsible for Passports