Vous êtes sur la page 1sur 3

The Nigeria Immigration Service 6/25/16, 1:39 AM

Standard ePassport Application Form


Important Information

Application Id: 10606812

Reference No: 1451361077

General Information
Title MR
Last name (Surname)
Ayeni

First name
Babatunde
Middle name
Michael
Gender Male
Date of birth (dd-mm-yyyy) 19 09 1987
Passport Booklet Type 64
Place of birth
Nigeria

Permanent Address (in Nigeria)


Address 1
House F3, Royal Estate
Address 2
Eric Moore rd.

City
Surulere
Country Nigeria
State Lagos
LGA Surulere
District

Postcode

Contact Information
State of Origin Ekiti

https://portal.immigration.gov.ng/passport/summary/chk/1/p/n/id/1E1G1J1I1H1C1Ki Page 1 of 3
The Nigeria Immigration Service 6/25/16, 1:39 AM

Nationality Nigeria
Home town
Aiyede-Ekiti
Contact phone
+08131686832

Email
babatunde.ayeni@gmail.com

Mobile phone

Occupation
Engineer
Maiden name

Personal Features
Marital status Single
Color of eyes Brown
Color of hair Black
Height (in cm)
178

Other Information
Special Features

Next of kin name


Ibiyemi Ayeni
Relationship with next of kin
Sister
Contact number of next of kin
+08126929676

Kin Address
Address 1
House F3, Royal Estate
Address 2
Eric Moore rd.

City
Surulere
Country Nigeria
State Lagos
LGA Surulere
District

Postcode

Passport Processing Country, State and Office


Processing State Lagos
Passport Office Ikoyi

https://portal.immigration.gov.ng/passport/summary/chk/1/p/n/id/1E1G1J1I1H1C1Ki Page 2 of 3
The Nigeria Immigration Service 6/25/16, 1:39 AM

Submission
Any false declaration on this form may lead to the withdrawal of the passport and/or prosecution of the applicant.

Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Signature / Thumb Impression: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

https://portal.immigration.gov.ng/passport/summary/chk/1/p/n/id/1E1G1J1I1H1C1Ki Page 3 of 3