AMASEZERANO Y’IGABANA RY’UBUTAKA BW’UBUHINZI KU BASANGIYE IBYANGOMBWA BY’UBUTAKA
Edition July 2021
FORM 10c
AMASEZERANO Y’IGABANA RY’UBUTAKA BW’UBUHINZI KU BASANGIYE IBYANGOMBWA BY’UBUTAKA
Twebwe,
1. ………………………………………………………............
Ufite Indangamuntu nimero:
2. ……………………………………………………………… Ufite Indangamuntu nimero:
3. ……………………………………………………………… Ufite Indangamuntu nimero:
Hashingiwe ku kuba dusangiye ubutaka bw’ubuhinzi (mu migabane) ku butaka bwanditse kuri
UPI …/...../…../…./……. buherereye mu Karere ka …………, Umurenge wa …………, Xxxxxxx ka ,
Umudugudu wa kubera ko kubuganyamo ibice bitari byemewe;
Hashingiwe xxxxx xx ifishi z’ibipimo by’ubutaka bwapimwe hakurikije igice buri wese atunze biri ku mugereka; Tugabanye ubutaka butwanditseho bubaruye kuri UPI .…/...../…../…../… ku buryo bukurikira:
1. ………………………………… ugatanyije na barandikwa ku butaka
bubaruye ku ifishi y’ibipimo nomero ……….
2. ………………………………… ugatanyije na barandikwa ku butaka
bubaruye ku ifishi y’ibipimo nomero ……….
3. ………………………………… ugatanyije na barandikwa ku butaka
bubaruye ku ifishi y’ibipimo nomero ……….
Abagabanye ubutaka:
Amazina Umukono
1. …………………………………………………………. Umukono: …………………………….
2. …………………………………………………………. Umukono: …………………………….
3. …………………………………………………………. Umukono: …………………………….
4. …………………………………………………………. Umukono: …………………………….
Bikozwe kuwa ……/……/…………
Bikorewe imbere ya ……………………………………………………… icyo ashinzwe: …………………………
Umukono na kashi……………………………