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Individual Staff Declaration Form: If More Than One, Please Mention Them All

This document is an individual staff declaration form for Biraboneye Fraterne providing personal details such as name, date of birth, address, education history, employment details, and loan repayment status. It confirms he received a government study loan and has started repaying it. The form is signed and dated by Biraboneye Fraterne to declare the information provided is true.

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Fraterne Biraboneye
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450 views1 page

Individual Staff Declaration Form: If More Than One, Please Mention Them All

This document is an individual staff declaration form for Biraboneye Fraterne providing personal details such as name, date of birth, address, education history, employment details, and loan repayment status. It confirms he received a government study loan and has started repaying it. The form is signed and dated by Biraboneye Fraterne to declare the information provided is true.

Uploaded by

Fraterne Biraboneye
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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INDIVIDUAL STAFF DECLARATION FORM

EMPLOYER/INSTITUTION: BIRABONEYE FRATERNE TIN………………


Phone Contact 0787608003
Email : [email protected]., Street :……………………………………, District :Huye
   
Family Name  BIRABONEYE
First Name  FRATERNE
National ID Nº  1199280130236005
Date of Birth 16/12/1992
RSSB Registration Nº  10993737Q
Mobile telephone of the staff  0787608003
Personal e-mail  [email protected]
Father's Names  MUDAHUNGA JEAN
Mother's Names  MUKAMUSANA JUNIS
Your Physical address Province : SOUTH District: HUYE Sector:RUSATIRA
Cell: KIRUHURA Village: RUGARAMA
Name of the University attended  UNIVERSITY OF RWANDA-COLLEGE OF EDUCATION
Country (Rwanda or Abroad)  RWANDA
Period of study (From……To……)   FROM 2012 TO 2014
Course attended/Faculty  MATHEMATICS-PHYSICS+EDUCATION
Registration Number 1189/13
Levels of Study (A1/A0/Masters/PhD)
*If more than one, please mention them all  A1
Month in which the staff was employed  JANUARY/2015
Current Gross Salary  
Other income (from you or spouse)  NONE
Did you benefit from gov't study loan/ bursasry?
Yes……../No……  YES
Did you receive a laptop? Yes…./No….  NO
Have you started to repay/ Yes.. …. /No ….... If
Yes in which Organisation/ Institution?  YES
Kindly write your request/Comment

 I would like to know amount of money that l have to repay, how


much l have paid and the remaing balance
   
Declaration :  
I, BIRABONEYE FRATERNE declare that the information provided on this form is true.
   
Done on the date of: 22./06/2022 Staff Signature : BIRABONEYE
   

P.O Box 1341, KN 3 Ave, Kigali – Rwanda | Toll-free 3288/0788388168 | Email: [email protected] | www.brd.rw
Development Bank of Rwanda Plc: A Public Company Limited by Shares; Authorized Share Capital Rwf 150,000,000,000
Company Code: 100003547, SWIFT CODE BRDRRWRW, VAT/TIN: 100003547

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