REPUBLIC OF NAURU

PASSPORTS (FORMS) REGULATIONS 2020

______________________________

SL No.  24 of 2020
______________________________

Notified: 20th August 2020
Table of Contents

1	Citation	
2	Commencement	
3	Application for ordinary Nauruan passport	
4	Details in Nauruan passports	
5	Application for refugee travel document	
6	Application for certificate of identity	
7	Refugee travel document	
8	Certificate of identity	
9	Cancellation of Nauruan travel document	
10	Notice for lost or stolen travel document	
11	Diplomatic passport	
12	Official passport	
13	Passport photograph requirements	
14	Register of travel documents	
SCHEDULE 1	
SCHEDULE 2	

Cabinet makes the following Regulations under Section 57 of the Passports Act 2011:

1	Citation

These Regulations may be cited as the Passports (Forms) Regulations 2020.

2	Commencement

These Regulations come into effect on the date of notification in the Gazette.

3	Application for ordinary Nauruan passport  

(1)	For the purpose of Section 7 of the Act, an application form for an ordinary Nauruan passport shall be in:

(a)	Form 1 of Schedule 1, if a Nauruan citizen by birth or descent; 

(b)	Form 2 of Schedule 1, if a naturalised citizen. 

(2)	An application under subregulation (1) shall be accompanied by the following:

(a)	2 recent photographs, one of which is to be certified:

(i)	by an authorised officer of the Passports Section in case of personal lodgement of application; and

(ii) in any other case, by a Commissioner for Oaths;

(b)	a birth certificate issued by the Registrar of Births Deaths and Marriages for a Nauruan citizen born in the Republic; 

(c)	a birth certificate from a foreign country of birth in case of a naturalised citizen; 

(d)	a certificate of registration of birth from the Registrar of Births Deaths and Marriages of a Nauruan citizen born in a foreign country or a birth certificate from the foreign country of birth where the birth is not registered in the Republic;  

(e)	marriage certificate;

(f)	an order of a court in case where the applicant is divorced and has not remarried;

(g)	death certificate of spouse in case of a widow;

(h)	a certificate of identity with photograph;

(i)	certificate of Nauruan citizenship in case of naturalised citizen;

(j)	in case of renewal of a passport, the biodata page of the expired or current passport and any other documents which the Secretary may require; 

(k)	such other information which the Secretary may deem necessary. 
4	Details in Nauruan passports

A Nauruan passport shall include the following details:
(a)	photograph;

(b)	secondary photograph showing as watermark;

(c)	passport type;

(d)	the Republic’s issuing code of ‘NRU’;

(e)	passport serial number:

(i)	for a Presidential passport – the letters ‘PN’ followed by 6 numerals;  

(ii)	for a diplomatic passport – the letters ‘DN’ followed by 6 numerals; 

(iii)	for an official passport – the letters ‘ON’ followed by 6 numerals; 

(iv)	for an ordinary Nauruan passport – the letters ‘NN’ followed by 6 numerals;

(f)	surname;

(g)	given names;

(h)	nationality;

(i)	date of birth;

(j)	gender;

(k)	place of birth;

(l)	date of issue; 

(m)	date of expiry;

(n)	issuing authority; and 

(o)	signature of holder. 
5	Application for refugee travel document 
       
(1)	For the purpose of Section 12 of the Act, an application form for a refugee travel document shall be in Form 3 of Schedule 1.

(2)	An application under subregulation (1) shall be accompanied by the following:

(a)	2 recent photographs, one of which to be certified by a Commissioner for Oaths;

(b)	Refugee Determination Record; 

(c)	Refugee Identification Card; 

(d)	birth certificate, if available;

(e)	marriage certificate, if available; 

(f)	death certificate of spouse in case of a widow, if applicable; and

(g)	such other information which the Secretary may deem necessary. 

6	Application for certificate of identity 

(1)	For the purpose of Section 12 of the Act, an application form for a certificate of identity shall be in:

(a)	Form 4 of Schedule 1 for:

(i)	a lost or stolen passport by a Nauruan citizen in a foreign country; 

(ii)	a foreigner overstaying in the Republic; and 

(iii)	a child born in the Republic to parents who are not Nauruan citizens; 

(iv)	an asylum seeker; or 

(b)	Form 5 of Schedule 1, for a Nauruan child born in a foreign country.

(2)	An application under subregulation (1) shall be accompanied by the following:

(a)	2 recent photographs, one of which to be certified:
(i)	by an authorised officer of the Passports Section in case of personal lodgement of application; and

(ii)	in any other case, by a Commissioner for Oaths;

(b)	a certificate of identity with photograph; 
(c)	birth certificate;
(d)	marriage certificate, if applicable; 
(e)	death certificate of spouse in case of a widow, if applicable;
(f)	final destination for travel; 
(g)	any such other information which the Secretary may deem necessary. 

(3)	Where a certificate of identity is required by a Nauruan citizen due to the loss or theft of passport whilst in a foreign country, the Secretary may issue a certificate of identity from the records kept in his or her custody, power or control. 

(4)	Where a certificate of identity is required for the travel of a child born of Nauruan descent in a foreign country, the Secretary may issue a certificate of identity for the child based on:

(a)	a certificate issued by a Nauruan embassy or consulate based in that foreign country certifying the child; 

(b)	in case where there is no Nauruan embassy or consulate, from the records of the biological mother of the child kept in the custody, power and control of the Secretary and a record of the hospital or medical facility where the child was born; and

(c)	such other requirements that the Secretary may deem necessary. 

7	Refugee travel document 

For the purpose of Section 13 of the Act, a refugee travel document shall include the following details:

(a)	photograph; 

(b)	surname;

(c)	given names;

(d)	gender;

(e)	nationality;

(f)	date of birth; 

(g)	document number – the letters ‘RS’ followed by 6 numerals; 

(h)	date of issue; 

(i)	date of expiry; 

(j)	signature of holder; and 

(k)	issuing authority. 
8	Certificate of identity 

(1)	For the purpose of Section 14 of the Act, a certificate of identity shall be in:

(a)	 Form 6 of Schedule 1 for:

(i) 	lost or stolen passport by a Nauruan citizen in a foreign country;

(ii) 	foreigner overstaying in the Republic;

(iii)	child born in the Republic to parents who are not Nauruan citizens;

(iv)	for a Nauruan child born in a foreign country;

(b)	Form 7 of Schedule 1 for an asylum seeker. 

(2)	For the purpose of subregulation (1), a certificate of identity shall include the following details:

(a)	photograph; 

(b)	surname;

(c)	given names;

(d)	gender;

(e)	nationality of origin;

(f)	date of birth; 

(g)	country of birth; 

(h)	signature of holder; 

(i)	final destination for travel; and 

(j)	issuing authority. 

(3)	The certificate of identity shall be valid for 12 months from the date of issue or earlier travel to the final destination.
9	Cancellation of Nauruan travel document 

For the purpose of Section 24 of the Act, the notice cancelling a Nauruan travel document shall be in Form 8 of Schedule 1.
10	Notice for lost or stolen travel document 

For the purpose of Section 33 of the Act, a notice for a lost or stolen travel document shall be in Form 9 of Schedule 1. 
11	Diplomatic passport

An application for a diplomatic passport shall be accompanied by the following:
(a)	approval by the Minister for office holders under Sections 8(2)(a),(b),(c), (d) and (e) of the Act; 

(b)	a supporting letter from the Department of Foreign Affairs for office holders under Sections 8(2)(c) and (d) of the Act; or

(c)	a decision of the Cabinet for a person under Section 8(2)(f) of the Act. 

12	Official passport

An application for an official passport shall be accompanied by the following:
(a)	a request by the relevant Head of Department; and 

(b)	approval by the Minister.  
13	Passport photograph requirements 

A passport photograph submitted under these Regulations shall have the following specifications:
(a)	be 4.5 centimetres x 3.5 centimetres;

(b)	have adequate brightness and contrast;

(c)	have natural skin tone;

(d)	have a close up of the head, ears and partial shoulders;

(e)	straight looking, centred with neutral expression;

(f)	the face shall be in sharp focus and clear with no ink marks, creases or lines;

(g)	the face, from forehead edge to bottom of chin, shall be seventy to eighty percent of the photograph; 

(h)	the eyes shall be open and no hair obstructing the face;

(i)	prescription glasses, if worn, shall be clear and thin framed and should not have flash reflection or obscure the eyes; 

(j)	head coverings, hair, head-dress or facial ornaments shall not obscure the face;

(k)	the photograph shall have plain light background;

(l)	there  shall be no other person or object in the photograph;

(m)	the lighting shall be uniform with no shadows on the face or behind;

(n)	photograph shall not have red eyes;

(o)	photograph with adequate digital resolution; and

(p)	shall be no more than 3 months old.

14	Register of travel documents 

For the purpose of Section 56 of the Act, the Register may be kept as set out in Schedule 2:

(a)	in writing; and 

(b)	electronic form that is readily available. 

SCHEDULE 1

FORM 1

REPUBLIC OF NAURU

[Passports Act 2011]

[Section 7; Regulation 3(1)(a)]

(Please provide 2 recent passport size photo of applicant)
(4.5 cm X 3.5cm)	

APPLICATION FORM FOR ORDINARY NAURUAN PASSPORT (NAURUAN CITIZEN BY BIRTH / DESCENT)

Documents required:

•	2 recent photographs, one of which to be certified:
(a)	by an authorised officer of the Passports Section in case of personal lodgement of application; and
(b)	in any other case, by a commissioner for oaths;
•	birth certificate issued by the Registrar of Births Deaths and Marriages for a Nauruan citizen born in the Republic; 
•	a birth certificate from a foreign country of birth in case of a naturalised citizen; 
•	a certificate of registration of birth from the Registrar of Births Deaths and Marriages of a Nauruan citizen born in a foreign country or a birth certificate from the foreign country of birth where the birth is not registered in the Republic;  
•	marriage certificate;
•	an order of a court in case where the applicant is divorced and has not remarried;
•	death certificate of spouse in case of a widow;
•	a certificate of identity with photograph;
•	certificate of Nauruan citizenship in case of naturalised citizen;
•	in case of renewal of a passport, the bio page of the expired or current passport and any other documents which the Secretary may require; 
•	any such other information which the Secretary may deem necessary. 
 	
PART 1 - PERSONAL DETAILS OF APPLICANT (tick where applicable)	
Title:

•	Mr 
•	Mrs 
•	Miss 
•	Ms 	Marital status:

•	Single 
•	Married 
•	Divorced
•	Widowed
	
Surname 		
Given names 		
Maiden name (if married female)		
Other names known by (if name change other than by marriage)		
Date of birth 		
Place of birth 		
Nationality 		
Gender (tick where applicable)	•	Male 
•	Female 	
Height (cm)		
Colour of eyes 		
Visible distinguishing marks 		
Usual residential address 		
Telephone 		
Email 		
Occupation (if applicable)		
Address of employer 		
PART 2 – PARTICULARS OF APPLICANT’S PARENTS 	
Full name of father 		
Date of birth of father 		
Nationality of father 		
Full name of mother 		
Date of birth of mother 		
Nationality of mother		
PART 3 – MARITAL STATUS OF APPLICANT (if applicable)	
Date of marriage (dd/mm/yy) 		
Country of marriage 		
PART 4 – IF APPLICANT IS A CHILD / PERSON WITH DISABILITY – CONSENT OF PARENT / PERSON WITH PARENTAL RESPONSIBILITY  OR GUARDIAN (if applicable)	

I, ……………………………………………………….. [full name of parent / person with parental responsibility or legal guardian], …………………………………………… [address], …………………………………………… [occupation], the ………………………………. [relationship with child or person with disability] of ………………………………………… [name of child or person with disability] hereby consent for ……………………………………….[name of child or person with disability] to hold a passport.

……………………………………….. [signature of parent / person with parental responsibility or guardian]

* ‘child’ means a person who is under 18 years of age and has never been married
	
PART 5 – DECLARATION OF APPLICANT / PARENT/ PERSON WITH PARENTAL RESPONSIBILITY OR GUARDIAN (tick where applicable)

I ……………………(state full name) of …………………….(residential address), ………………. (occupation), do solemnly and sincerely declare that (set out matter declared, using numbered paragraphs if it is lengthy):
•	I have completed this application form for someone else aged 18 years or over because they have a disability.

•	Declare that the information given in this application is correct to the best of my knowledge and belief.

•	That …………………………………. [name of applicant] has not lost the status of Nauruan citizenship. 

………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
[additional information] 

And I make this solemn declaration by virtue of the Oaths, Affirmations and Statutory Declarations Act 1976 conscientiously believing in the statement contained therein to be true in every particular.
Signed by the applicant / parent / person with parental responsibility or guardian: ………………………………………
Name of person filing this form: …………………………………………
Declared at……………………….this…………………day of …………….. 20…
Before me:
(Signature)
(Title)
NOTE: Under the Oaths, Affirmations and Statutory Declarations Act 1976, any person making a false statement is guilty of an offence and is liable to imprisonment for 5 years.

Under Section 25 of the Passports Act 2011, a person commits an offence if the person gives information to another person in relation to an application for a Nauruan travel document and the information is misleading and the person is reckless about whether the information is misleading. Penalty: $20,000 and 10 years imprisonment. 	

Payment receipt no: …………………….
	
OFFICIAL PURPOSES 
Received by:  …………………………. 
                       (Full name of officer)
Date:    /    / 20…..             	

	

FORM 2

REPUBLIC OF NAURU

[Passports Act 2011]

[Section 7; Regulation 3(1)(b)]

(Please provide 2 recent passport size photo of applicant)
(4.5 cm X 3.5cm)	

APPLICATION FORM FOR ORDINARY NAURUAN PASSPORT (NATURALISED CITIZEN)

Documents required:

•	2 recent photographs, one of which to be certified:
(a)	by an authorised officer of the Passports Section in case of personal lodgement of application; and
(b)	in any other case, by a commissioner for oaths;
•	birth certificate issued by the Registrar of Births Deaths and Marriages for a Nauruan citizen born in the Republic; 
•	a birth certificate from a foreign country of birth in case of a naturalised citizen; 
•	a certificate of registration of birth from the Registrar of Births Deaths and Marriages of a Nauruan citizen born in a foreign country or a birth certificate from the foreign country of birth where the birth is not registered in the Republic;  
•	marriage certificate;
•	an order of a court in case where the applicant is divorced and has not remarried;
•	death certificate of spouse in case of a widow;
•	a certificate of identity with photograph;
•	certificate of Nauruan citizenship in case of naturalised citizen;
•	in case of renewal of a passport, the bio page of the expired or current passport and any other documents which the Secretary may require; 
•	any such other information which the Secretary may deem necessary. 
 	
PART 1 - PERSONAL DETAILS OF APPLICANT (tick where applicable)	
Title:

•	Mr 
•	Mrs 
•	Miss 
•	Ms 	Marital status:

•	Single 
•	Married 
•	Divorced
•	Widowed
	
Surname 		
Given names 		
Maiden name (if married female)		
Other names known by (if name change other than by marriage)		
Date of birth 		
Place of birth 		
Nationality 		
Gender (tick where applicable)	•	Male 
•	Female 	
Height (cm)		
Colour of eyes 		
Visible distinguishing marks 		
Usual residential address 		
Telephone 		
Email 		
Occupation (if applicable)		
Address of employer 		
PART 2 – PARTICULARS OF APPLICANT’S PARENTS 	
Full name of father 		
Date of birth of father 		
Nationality of father 		
Full name of mother 		
Date of birth of mother 		
Nationality of mother		
PART 3 – MARITAL STATUS OF APPLICANT (if applicable)	
Date of marriage (dd/mm/yy) 		
Country of marriage 		
PART 4 – CITIZENSHIP OF APPLICANT 

Applicant is a Nauruan citizen by: (tick where applicable)

•	Birth in the Republic and residency (Section 11 of the Naoero Citizenship Act 2017) – provide copy of Nauruan Certificate of Citizenship 
•	Marriage (Section 13 of the Naoero Citizenship Act 2017) – provide copy of Nauruan Certificate of Citizenship
•	Adoption (Section 15 of the Naoero Citizenship Act 2017) – provide copy of Nauruan Certificate of Citizenship
•	Minor / dependant (Section 19A of the Naoero Citizenship Act 2017) – provide copy of Nauruan Certificate of Citizenship
	
PART 5 – IF APPLICANT IS A CHILD / PERSON WITH DISABILITY – CONSENT OF PARENT / PERSON WITH PARENTAL RESPONSIBILITY  OR GUARDIAN (if applicable)	

I, ……………………………………………………….. [full name of parent / person with parental responsibility or legal guardian], …………………………………………… [address], …………………………………………… [occupation], the ………………………………. [relationship with child or person with disability] of ………………………………………… [name of child or person with disability] hereby consent for ……………………………………….[name of child or person with disability] to hold a passport.

……………………………………….. [signature of parent / person with parental responsibility or guardian]

* ‘child’ means a person who is under 18 years of age and has never been married

	
PART 6 – DECLARATION OF APPLICANT / PARENT/ PERSON WITH PARENTAL RESPONSIBILITY OR GUARDIAN (tick where applicable)

I ……………………(state name) of …………………….(residential address), ……………….(occupation), do solemnly and sincerely declare that (set out matter declared, using numbered paragraphs if it is lengthy):
•	I have completed this application form for someone else aged 18 years or over because they have a disability.

•	Declare that the information given in this application is correct to the best of my knowledge and belief.

•	That …………………………………. [name of applicant] has not lost the status of Nauruan citizenship. 

………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
[additional information] 

And I make this solemn declaration by virtue of the Oaths, Affirmations and Statutory Declarations Act 1976 conscientiously believing in the statement contained therein to be true in every particular.
Signed by the applicant / parent / person with parental responsibility or guardian: ………………………………………
Name of person filing this form: …………………………………………
Declared at……………………….this…………………day of …………….. 20…….. 
Before me:
(Signature)
(Title)
NOTE: Under the Oaths, Affirmations and Statutory Declarations Act 1976, any person making a false statement is guilty of an offence and is liable to imprisonment for 5 years.

Under Section 25 of the Passports Act 2011, a person commits an offence if the person gives information to another person in relation to an application for a Nauruan travel document and the information is misleading and the person is reckless about whether the information is misleading. Penalty: $20,000 and 10 years imprisonment. 	

Payment receipt no: …………………….
	
OFFICIAL PURPOSES 
Received by:  …………………………. 
                       (Full name of officer)
Date:    /    / 20…..             	

 FORM 3

REPUBLIC OF NAURU

		[Passports Act 2011] 

[Section 12; Regulation 5(1)]

(Please provide 2 recent passport size photo of applicant)
(4.5 cm X 3.5cm)	

APPLICATION FORM FOR REFUGEE TRAVEL DOCUMENT  

Documents required:

•	2 recent photographs, one of which to be certified by a commissioner for oaths;
•	Refugee Determination Record; 
•	Refugee Identification Card;
•	birth certificate, if available;
•	marriage certificate, if available; 
•	death certificate of spouse in case of a widow, if applicable;
•	any such other information which the Secretary may deem necessary.
	
PART 1 – PERSONAL DETAILS OF APPLICANT 	
Surname 		
Given names 		
Place of birth 		
Country of birth 		
Present citizenship or nationality 		
Date of birth 		
Gender (tick where applicable)	•	Male 
•	Female
	
Height (cm)		
Colour of eyes 		
Visible distinguishing marks		
Usual residential address 		
Telephone 		
Email 		
Occupation (if applicable)		
Address of employer 		
PART 2 – CONSENT FOR ISSUE OF REFUGEE TRAVEL DOCUMENT TO CHILD (if applicable)	
•	Fill in this part only if this application is for a child under the age of 18 years old. 
•	Consent can only be given by a parent named on the child’s birth record / person with parental responsibility or guardian. 
•	Tick the box below that shows your relationship to the child in this application:
•	Mother 
•	Father 
•	Person with parental responsibility 
•	Guardian 
	
Surname 		
Given names 		
Date of birth 		
Residential address		
Telephone		
Email		

I hereby consent for a travel-document to be issued to the child in this application. 

…………………………………………                   Date: ….. / ……………….. / 20……
Signature 
	
PART 3 – DECLARATION OF APPLICANT / PARENT / PERSON WITH PARENTAL RESPONSIBILITY OR GUARDIAN (tick where  applicable)	

•	I am 18 years of age or older. 
•	I have completed this application for a child under 18 years of age. 
•	I am 18 years of age or older and someone else has filled in this application for me because I have a disability or language difficulty.

•	I declare that the information I have given in this application is, to the best of my knowledge, true, complete and correct. 
•	I understand that my Refugee Travel Document may be cancelled and I can be fined or imprisoned in accordance with Nauruan laws if I have provided false information. 
•	I agree that, for the purposes of this application, other government agencies may release personal information about myself which will assist the Passports Section in determining my entitlement to be issued with or continue to hold a Refugee Travel Document. 
•	I understand that if I have possession of a false Nauruan travel-document, I may be liable on conviction to a fine of $20,000 and 10 years imprisonment. 
	
Full name 		
Residential address 		
Telephone		
Email		
And I make this solemn declaration by virtue of the Oaths, Affirmations and Statutory Declarations Act 1976 conscientiously believing in the statement contained therein to be true in every particular.
Signed by the applicant / parent / person with parental responsibility or guardian: ………………………………………
Name of person filing this form: …………………………………………
Declared at……………………….this…………………day of ……………..20…….. 
Before me:
(Signature)
(Title)
NOTE: Under the Oaths, Affirmations and Statutory Declarations Act 1976, any person making a false statement is guilty of an offence and is liable to imprisonment for 5 years.

Payment receipt no: …………………….
	
OFFICIAL PURPOSES 
Received by:  …………………………. 
                       (Full name of officer)
Date:    /    / 20…..             	

FORM 4

REPUBLIC OF NAURU

		[Passports Act 2011] 

[Section 12; Regulation 6(1)(a)]

(Please provide 2 recent passport size photo of applicant)
(4.5 cm X 3.5cm)	

APPLICATION FORM FOR CERTIFICATE OF IDENTITY (LOST OR STOLEN PASSPORT BY A NAURUAN CITIZEN IN FOREIGN COUNTRY / FOREIGNER OVERSTAYING IN THE REPUBLIC / CHILD BORN IN THE REPUBLIC TO PARENTS WHO ARE NOT NAURUAN CITIZENS / ASYLUM SEEKER)
Reason for applying:  [tick where applicable]

•	Lost / stolen passport by a Nauruan citizen in a foreign country
•	Foreigner overstaying in the Republic
•	Child born in the Republic to parents who are not Nauruan citizens 
•	Asylum seeker

Documents required:

•	2 recent photographs, one of which to be certified:
(a)	by an authorised officer of the Passports Section in case of personal lodgement of application; and
(b)	in any other case, by a commissioner for oaths;
•	a certificate of identity with photograph; 
•	birth certificate;
•	marriage certificate, if applicable; 
•	death certificate of spouse in case of a widow, if applicable;
•	final destination for travel; 
•	any such other information which the Secretary may deem necessary. 
	
PART 1 – PERSONAL DETAILS OF APPLICANT 	
Surname 		
Given names 		
Place of birth 		
Country of birth 		
Present citizenship or nationality 		
Date of birth 		
Gender (tick where applicable)	•	Male 
•	Female
	
Height (cm)		
Colour of eyes 		
Visible distinguishing marks		
Usual residential address 		
Telephone 		
Email 		
Occupation (if applicable)		
Address of employer 		
PART 2 – PARTICULARS OF PARENTS 	
Full name of father 		
Date of birth of father 		
Nationality of father 		
Full name of mother 		
Date of birth of mother 		
Nationality of mother 		
PART 3 – MARITAL STATUS OF APPLICANT (if applicable)	
Date of marriage (dd/mm/yy)		
Country of marriage 		
PART 4 – CONSENT FOR ISSUE OF CERTIFICATE OF IDENTITY TO CHILD BORN TO PARENTS WHO ARE NOT NAURUAN CITIZENS	
•	Fill in this part only if this application is for a child under the age of 18 years old. 
•	Consent can only be given by a parent named on the child’s birth certificate / person with parental responsibility or guardian. 
•	Tick the box below that shows your relationship to the child in this application.

•	Mother 
•	Father 
•	Person with parental responsibility 
•	Guardian 
	
Surname 		
Given names 		
Date of birth 		
Residential address		
Telephone		
Email		

I hereby consent for a travel-document to be issued to the child in this application. 

…………………………………………                   Date: ….. / ……………….. / 20……
Signature 
	
PART 5 – DECLARATION OF APPLICANT / PARENT / PERSON WITH PARENTAL RESPONSIBILITY OR GUARDIAN (tick where applicable)	
•	I have completed this application form for someone else aged 18 years or over because they have a disability or language difficulty.
•	I / the applicant wear(s) a head covering or headband in the supplied photo for medical or religious reasons. 
•	I am 18 years of age or older and someone else has filled in this application for me because I have a disability or language difficulty.	
Full name 		
Residential address 		
Telephone		
Email		

•	I agree that I will return my Certificate of Identity if I obtain a passport or citizenship of any country. 
•	I declare that the information I have given in this application is, to the best of my knowledge, true, complete and correct. 
•	I understand that my Certificate of Identity will be cancelled and I may be fined or imprisoned in accordance with Nauruan laws if I have provided false information. 
•	I agree that, for the purposes of this application, other government agencies may release personal information about myself which will assist the Passports Section in determining my entitlement to be issued with or continue to hold a Nauruan travel document. 
•	I understand that if I have possession of a false Nauruan travel-document, I may be liable on conviction to a fine of $20,000 and 10 years imprisonment. 

And I make this solemn declaration by virtue of the Oaths, Affirmations and Statutory Declarations Act 1976 conscientiously believing in the statement contained therein to be true in every particular.
Signed by the applicant / parent / person with parental responsibility or guardian: ………………………………………
Name of person filing this form: …………………………………………
Declared at……………………….this…………………day of ……………..20…….. 
Before me:
(Signature)
(Title)
NOTE: Under the Oaths, Affirmations and Statutory Declarations Act 1976, any person making a false statement is guilty of an offence and is liable to imprisonment for 5 years.

Payment receipt no: …………………….
	
OFFICIAL PURPOSES 
Received by:  …………………………. 
                       (Full name of officer)
Date:    /    / 20…..             	

FORM 5

REPUBLIC OF NAURU

		[Passports Act 2011] 

[Section 12; Regulation 6(1)(b)]
(Please provide 2 recent passport size photo of applicant)
(4.5 cm X 3.5cm)	

APPLICATION FORM FOR CERTIFICATE OF IDENTITY (NAURUAN CHILD BORN IN FOREIGN COUNTRY)

Documents required:

•	2 recent photographs, one of which to be certified:
(a)	by an authorised officer of the Passports Section in case of personal lodgement of application; and
(b)	in any other case, by a commissioner for oaths;
•	passport biodata page of mother of child, if case where there is no Nauruan embassy or consulate based in the foreign country where Nauruan child was born; 
•	certificate issued by Nauruan embassy or consulate based on that foreign country certifying the child;
•	final destination for travel; 
•	any such other information which the Secretary may deem necessary. 
	
PART 1 - DETAILS OF CHILD 	
Surname 		
Given names		
Date of birth		
Place of birth 		
Current country of residence 		
PART 2 – CONSENT FOR ISSUE OF CERTIFICATE OF IDENTITY TO CHILD (tick where applicable)	
•	Fill in this part only if this application is for a child. 
•	Consent can only be given by a parent named on the child’s birth record / person with parental responsibility. 
•	Tick the box below that shows your relationship to the child in this application.

•	Mother 
•	Father 
•	Person with parental responsibility 
•	Guardian 
	
Surname 		
Given names 		
Date of birth 		
Residential address		
Telephone		
Email		
PART 2 - DECLARATION OF PARENT 	

I have completed this application form for my child aged ……………… (months / years).
	
Full name 		
Residential address 		
Telephone		
Email		
And I make this solemn declaration by virtue of the Oaths, Affirmations and Statutory Declarations Act 1976 conscientiously believing in the statement contained therein to be true in every particular.
Signed by the parent / person with parental responsibility: ………………………………………
Name of person filing this form: …………………………………………
Declared at……………………….this…………………day of ……………..20…….. 
Before me:
(Signature)
(Title)
NOTE: Under the Oaths, Affirmations and Statutory Declarations Act 1976, any person making a false statement is guilty of an offence and is liable to imprisonment for 5 years.

Payment receipt no: …………………….
	
OFFICIAL PURPOSES 
Received by:  …………………………. 
                       (Full name of officer)
Date:    /    / 20…..             	

FORM 6

REPUBLIC OF NAURU

[Passports Act 2011]

[Section 14; Regulation 8(1)(a)]
CERTIFICATE OF IDENTITY 
[Lost or stolen passport by a Nauruan citizen in a foreign country / Foreigner overstaying in the Republic / Child born in the Republic to parents who are not Nauruan citizens / Nauruan child born in a foreign country]

COI No. … / 20… 

(Please provide 2 recent passport size photo of applicant)
(4.5 cm X 3.5cm)	

This Certificate of Identity is issued to …………………………………………… [full name] under Section 14 of the Passports Act 2011. 

DETAILS 	
Gender 		
Nationality of origin 		
Date of birth 
		
Place of birth		
Country of birth 		
Final destination for travel 		

This Certificate is valid for 12 months from the date of issue and or void once reached final destination. 

Issued this         day of                            20….

Minister for Justice and Border Control

FORM 7

REPUBLIC OF NAURU

[Passports Act 2011]

[Section 14; Regulation 8(1)(b)]
CERTIFICATE OF IDENTITY – ASYLUM SEEKER 

ASTD No: … / 20… 

(Please provide 2 recent passport size photos of applicant)
(4.5 cm X 3.5cm)	

This Certificate is issued to …………………………………………… [full name] under Section 14 of the Passports Act 2011. 

DETAILS 	
Gender 		
Nationality 		
Date of birth (if applicable)
		
Place of birth 		
Signature of holder 		

This Certificate is issued to enable the holder to travel to ……………………………. [foreign destination] and return to the Republic of Nauru. 

The holder must immediately surrender to an authorised officer this Asylum Seeker Travel Document on return to the Republic. 

This Certificate is valid for 12 months from the date of issue and or void once reached final destination. 

Issued this         day of                            20….

Minister for Justice and Border Control

FORM 8

REPUBLIC OF NAURU

[Passports Act 2011]

NOTICE CANCELLING NAURUAN TRAVEL DOCUMENT 

[Section 24; Regulation 9]

Notice No: CNTD… / 20…			
To:	
             ……………………………………………….[ Name of holder ]
	……………………………………………….[Residential address]
             ………………………………………………. [ Travel document number]
             ………………………………………………. [Travel document type] 

TAKE NOTICE that your travel document is cancelled forthwith due to:

•	Section 7(1), you are not a Nauruan citizen and I am not satisfied with your identity
•	Section 12(1), I am not satisfied with your identity and you are disqualified for the issue of a travel-related document under Division 2 of the Passports Act 2011
•	Section 15(1), each person who has parental responsibility for the child has not consented to the child travelling internationally 
•	Section 16(a), a warrant for your arrest is in force in Nauru in relation to a serious offence against a law of Nauru
•	Section 16(b), you being prevented from travelling internationally under a law of Nauru or an order or other direction made under a law of Nauru 
•	Section 21, concurrently valid Nauruan travel document 
•	Section 24(2)(a), I intend to issue another travel document to you immediately after cancelling the document
•	Section 24(2)(b), the document has been lost or stolen
•	Section 24(2)(c), I have been made aware of a circumstance that permits me to refuse to issue the document to you under Section 17 of the Passports Act 2011 – international law enforcement matter
•	Section 24(2)(c), I have been made aware of a circumstance that permits me to refuse to issue the document to you under Section 18 of the Passports Act 2011 – potential harmful conduct 
•	Section 24(2)(c), I have been made aware of a circumstance that permits me to refuse to issue the document to you under Section 19 of the Passports Act 2011 – repeated loss or theft 
•	Section 24(2)(c), I have been made aware of a circumstance that permits me to refuse to issue the document to you under Section 20 of the Passports Act 2011 – debt owed to Nauru 

Dated this …… day of …………………………20…

……………………………………….
Minister for Justice and Border Control 

FORM 9

REPUBLIC OF NAURU

[Passports Act 2011]

NOTICE FOR LOST OR STOLEN TRAVEL DOCUMENT 

[Section 33; Regulation 10]

Type of travel document:
•	ordinary Nauruan passport 
•	official passport 
•	diplomatic passport
	
To: Authorised officer 
	
Surname 		
Given names 		
Residential address		
Telephone		
Email		
Date passport lost / stolen 		
Place where passport lost / stolen 		
Police report made	•	attach copy of police report 

And I make this solemn declaration by virtue of the Oaths, Affirmations and Statutory Declarations Act 1976 conscientiously believing in the statement contained therein to be true in every particular.

Signed by the applicant / parent / person with parental responsibility or guardian: ………………………………………
Declared at……………………….this…………………day of ……………..20…….. 
Before me:
(Signature)
(Title)

NOTE: Under the Oaths, Affirmations and Statutory Declarations Act 1976, any person making a false statement is guilty of an offence and is liable to imprisonment for 5 years.	

Payment receipt no: …………………….	
OFFICIAL PURPOSES 

Received by:  …………………………. 
                       (Full name of officer)
Date:    /    / 20…..             
	
SCHEDULE 2

REPUBLIC OF NAURU

[Passports Act 2011]

REGISTER OF TRAVEL DOCUMENTS 

[Section 56; Regulation 14]

Name of applicant 	Date of application 	Date of issue 	Passport Number	Passport Type 	Date of expiry 	Date cancelled (if applicable)