8.
Marital Status
Maried (Ameoa/ameolewa)
(Hali ya ndoa) Single (Hajaoa/hajaolewa)
Divorced (Ameachika)
Religious (Mtawa)
Widowed (Mjane)
9. Bank Address……………………………………………………………………………………………….
(Jina na anwani ya Benki)
10. Account Number ……………………………………………………………………………….
11. A part from your involvement in artistic and literary works, do you have any full time
employment with any government department/organization/company?
(Mbali na ushiriki wako katika sanaa unayo ajira penginepo)
Yes/Ndiyo ……………………………………. No/hapana
If yes, name and address of the
government/department/organization/company concerned or employing
you.
(Kama ndiyo, taja jina na anwani ya mwajiri)
12.
13.
Are you a member of any other Copyright Society?
(Wewe ni mwanachama wa Chama/Asasi nyingine yeyote ya
hakimiliki?)
(Yes/Ndiyo ………………………………
No/ Hapana ………………………..
Inheritance information – I hereby declare the following to be my heir(s)
of my art works and receive Royalties after my death
(Natamka kuwa wafuatao watakuwa warithi wa kazi zangu za sanaa na
watapokea mirabaha baada ya kifo changu).
Name…………………………………………Relationship …………………………………
(uhusiano)……………………………………
(Jina)
Name…………………………………………Relationship …………………………………
(uhusiano)……………………………………
(Jina)
Name…………………………………………Relationship …………………………………
(uhusiano)……………………………………
(Jina)
Name…………………………………………Relationship …………………………………
(uhusiano)……………………………………
(Jina)
6