8th April, 2004 Statutary_Instruments 107 GOVERNMENT OF ZAMBIA STATUTORY INSTRUMENT No. 40 OF 2004 The Births and Deaths Registration Act (Laws, Volume 5, Cap. 51) The Births and Deaths Registration (General) (Amendment) (No. 2) Rules, 2004 IN EXERCISE of the powers contained in section twenty-one of the Births and Deaths Registration Act, the following Rules are hereby made: I. These Rules may b e cited as the Births and Deaths Registration (General) (Amendment) (No .2) Rules, 2004, and shall be read as one with the Births and Deaths Registration (General) Rules, in these Rules referred to as the principal Rules. Title Cap. 51 2. The First Schedule to the principal Rules is amended by the revocation of Registration General Form No. 25 and the substitution therefor of the form set out in the Appendix of these Rules. Amendment of First Schedule Copies of this Statutory Instrument can be obtained from the Government Printer, P.O. Box 30136, Lusaka, Price KSOO each 108 Statutory Instruments 8th April, 2004 Fonn J (Rule 8) APPENDIX (Paragraph 2) Reg-Gen. Form No. 18(Rev.) Stocked by the Regist;..r- General, Lusaka REPUBLIC .OF ZAMBIA DEATH CERTIFICATE No. OOOOOOA Certificate No. ,, ..................... ,.............................. District .. , ...................... , ... . Date of death ............................................. , ............................ , ........................... . Place of death .................................................................. • .................................. . Names and surname �f deceased ........................................................... , ............ . Sex ................................................................. Age ........................................... .. Nationality of deceased .......................................................................................... . Occupation ........................................................................................................ . NAPSA Social Security Number, if any ............................................................. . Cause of death .......................................................................... , ........................ . ........................................................................................................................... Name of informant. ............................................................................................ . Relationship to deceased ..................................................................................... . Infonnant's residential address ........................................................................... . ............................................................................................................................ Date of registration ............................................................................................ . Name of Registrar ............................................................................. : ............... .. I hereby certify that the above certificate is a true copy of the particulars registered in relation to the death of tbe person named in the register of deaths kept at Lusaka. Dated this ................................... day of.................................. . ...................... . Registrar LUSAKA 31st-March, 2004 R. S. SHIKAPWASHA, Minister of Home Affairs
