REPUBLIC OF BOTSWANA

APPLICATION FOR CUSTOMARY LAND RIGHTS

1. Full names of applicant……………………………………………………………………………… 2. Postal Address……………………………………………….Tel:No……………………………….

3. Date of Birth:…………………………… ………4. Age……………………. 5. Man/Woman*

6. Are you citizen of Botswana? Yes/No* ID No……………………………………

7. Marital Status: Married/Single/Divorced/Separated/Widowed.* 8. If married, name of spouse ………………………………………………………………………….

9. Name of place where plot applied for is …………………………………………………….……

10. Present use of the plot applied for ………………………………………………………………….

11. Size of plot applied for …………………………………………………………………………….

12. Proposed use: (a) residential (b) ploughing

© cemetery (d) Others: specify ……………………………………. 13. Is the site applied for debushed. Yes/No*

14. List in full the names of people whom you have consulted who hold land bordering the plot which you are applying ……………………………………………………………………. …………………………………………………………………………………………………………. …………………………………………………………………………………………………………. 15. List any other land rights you possess anywhere in the Country.

………………………………………………………………………………………………………….. 16. Are all the sites mentioned above developed? Yes/No*

If no give reasons …………………………………………………………………………………… *Delete words which do not apply

17. I ……………………………………………..state that the above information is complete and

(full name of applicant) correct. I understand that the discovery of incorrect or false information on the application shall result in the rejection of my application and/or prosecution and/or forfeiture of the plot if already granted to me.

………………………………………………………….. ………………………………… (Signature of Applicant) (Date) RECOMMENDATION BY LAND OVERSEER 18. I ……………………………………………………………………confirm that the plot applied for

(full name of Land Overseer) above:

(a) has been allocated/not been allocated.* (b) its allocation will interfere/not interfere with other people with other people’s rights* (c) the proposed use will/will not conflict with the land use in the area*

………………………………………………………. ………………………….. (Signature of Land Overseer) (Date) *Delete words which do not apply