Next of kin form Kenya
TEACHERS SERVICE COMMISSION, TSC, NEXT OF KIN FORM
Telephone: Nairobi 2892000 0722208552/0777208552 Email [email protected]
Website www.tsc.go.k
TSC HOUSE
KILIMANJARO ROAD UPPER HILL
PRIVATE BAG
NAIROBI, KENYA
TEACHERS NEXT-OF-KIN FORM
- NOTES
- a) The next of kin will automatically assume the role of legal personal representative.
- b) Relationship means : Husband/Wife/Son/Daughter/Father/Mother e.t.c
- c) Any change on the teacher’s records should be communicated immediately by the teacher to the Commission.
- NAME TSC No. ID/No.
(Full name in block letters)
- Date of first appointment as (a) Untrained Teacher (UT)
(b) Trained Teacher (P/P)
- PERMANENT ADDRESS – P. O. Box ,Code,Town
- HOME DISTRICT , DIVISION ,LOCATION
- DECLARATION:
I, Mr/Mrs/Miss/Dr/. ,ID/No.
hereby declare/ nominate the following as my next of kin and dependants:-
NEXT OF KIN
S/N | NAME(S) | AGE | RELATION | CONTACT
ADDRESS/PHONE |
1. | ||||
2. | ||||
3. | ||||
4. | ||||
5. |
DEPENDANTS
S/N | NAME(S) | AGE | RELATION | CONTACT
ADDRESS/PHONE |
1. | ||||
2. | ||||
3. | ||||
4. | ||||
5. | ||||
6. | ||||
7. | ||||
8. | ||||
9. | ||||
10. |
- TEACHER’S SIGNATURE , DATE
- NAME AND ADDRESS OF AREA CHIEF
- HEADTEACHER/DEPUTY HEADTEACHER/WITNESS
Name Address
Sign. , Date
Official Stamp:
Download the pdf copy here.
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