Tel. ( ) RECEIPT #………..………………..

Republic of Guyana National I. D. No……………..…….…..

FORM 1-3

APPLICATION FOR RENEWAL OF PASSPORT

This form must be completed by all applicants in their own handwriting

(1) I, the undersigned………………………………………………………………………………………………………

Surname First Middle

born at……………………………………………………(place) on / / / / / / /
Month Day Year
maiden name (if a married woman or widow)…………………………………………………………….……………

at present residing at………………………………………………………………….………………………………...

hereby make application for the renewal of the attached Republic of Guyana Passport

No………………………...issued to me at:…………… …………….on / / / / / / /

Month Day Year

for a further period of Five years for the purpose of traveling to all Commonwealth & Foreign Countries.

OCCUPATION:…………………………………………

(2) MARRIED WOMAN

(a) If wife of bearer is included on the Passport, state

National
Full names:…………………………………………………………………I.D. No:……………………………...……
Wife’s address (present)……………………………………………………………………………………....…………
Place and date of birth………………………………………………………………………………..……………….…
Maiden surname:…………………………………………Present occupation:……………………………...…………

(b) If applicant is a married woman or a widow, state

Husband’s Full Names…………………………………………………………………………………………………..

Husband’s place of birth …………………………Husband’s date of birth / / / / / / /

Month Day Year
Husband’s address (present)…………………………………………………………………………………………….

(3) DECLARATION

I declare that I am a Citizen of the Republic of Guyana and that all the particulars given by me in respect of this
application are true.
I further declare that I have no other valid Passport or other Travel Document issued by the State of Guyana in my
possession.

Signature of Applicant………………………………………… Date: ………………………………

WARNING:- Applicants are warned that should any of the statements contained in their declarations prove to be
untrue, the consequences to them may be serious.

Two Photographs of the applicant must be presented with this application.

(2) PHOTO
2
C$50.00

1.75” x 1.5”
or
45mm x 38mm

Signature of holder: …………………………………………….

Date: …………………..…………….…………..
 SUPPLEMENTARY INFORMATION

NOTES

(1) Application for the renewal of Republic of Guyana Passports should be presented to the Consulate
General of Guyana, 505 Consumers Rd., Suite 206, Toronto, Ontario M2J 4V8

(2) A Passport which has been in existence for fifteen years or longer or which contains no further space
for visas is not renewable and the holder must apply for a new Passport.

(3) A Passport may be renewed for consecutive periods of one to five years FROM THE DATE
OF EXPIRY. The renewal fee of C$50.00 payable by certified Cheque, Cash or Money Order
must be presented with a completed and signed passport renewal application form and two (2)
photographs taken within the last six months, with size of 1.75” x 1.5” or 45mm x 38mm. The
back of the photographs must be date stamped by the photo studio. Photographs taken in
portable kiosks are not acceptable.

(4) Evidence in support of statements made in Section 1 and 2 may be required.

(5) When a Passport is presented by an unmarried person under 18 years of age, the consent (in

writing) of the father or other legal guardian is required. The child’s/children’s Birth Certificate and

father/legal guardian passport must be presented.

OUTSTANDING ITEMS/ISSUES DATE WHOM

(a)

(b)

(c)

(d)

RECEIVED BY Date .

PREPARED BY Date__________

SIGNED OUT BY Date__________

PICKED UP Date ____ .

Pol.-13

THIS SPACE TO BE LEFT BLANK FOR USE AT THE PASSPORT OFFICE