NATIONAL REVENUE AUTHORITY
Application for Employment
(To be completed in applicant’s own handwriting)
Attach Signed
Passport
Photograph Here
1. Position applied for:………………………………………………………………...........................
2. First Name:………………………………………………………………………………………….
Middle Name:………………………………………………………………………………………
Family Name:……………………………………………………………………………………….
3. Present Address and Telephone No:………………………………………………………………..
……………………………………………………………………………………………………..
Mailing Address:……………………………………………………………………………………
E-mail Address:…………………………………………………………………………………….
4. Nationality:…………………………………………………………………………………………
Date and Place of Birth:…………………………………………………………………………….
5. Sex: Male Female
6. Marital Status: Single Married Divorced Widow Widower
Names and ages of Children: Name:……………………………………..Age………….
Name:……………………………………..Age………….
Name……………………………………...Age………….
Name………………………………………Age…………
Name………………………………………Age…………
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7. (a) Name, Address and Telephone No, Email Address of Next of Kin to be contacted in case
of emergency
………………………………………………………………………………………………
………………………………………………………………………………………………
(b) Relationship:……..…………………………………………………………………………
8. Name, Address and Telephone No, Email Address of Beneficiary(s) to whom benefit should be
paid in case of death of employee:
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
9. Universities/Colleges attended
Years Attended Certificate/Degree Obtained
Name and Address From To Obtained Class
10. Schools Attended Date Examination Passed
…………………………………………. ………………………. ………………………
…………………………………………. ………………………. ………………………
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11. Any Other Professional Qualifications/Specialized Training?
………………………………………………………………………………………………………
………………………………………………………………………………………………………
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Name and Address of Tutor, Head of Department from where reference may be obtained.
………………………………………………………………………………………………………
………………………………………………………………………………………………………
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12. Previous employment (including Recent Employer, if any):
Name of Employer Date Nature of Work
………………………………………. ………………. ………………………………
………………………………………. ………………. ………………………………
………………………………………. ………………. ………………………………
13. Relatives Employed in the Institution:
Name Relationship
……………………………………………………….. ………………………………
……………………………………………………….. ………………………………
Why are you interested in working in the NRA?
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14. Names, Addresses and Telephone Nos, Email Address of 2 people of standing (relatives included
that can provide academic/character reference):
………………………………………………………..……………………………………………..
………………………………………………………..……………………………………………..
15. Medical Status
………………………………………………………………………………………………………
16. Have you ever been convicted of any criminal offence?
………………………………………………………………………………………………………
17. If appointed how soon would you be ready to start work?
………………………………………………………………………………………………………
18. Declaration
I declare that the information and statement provided by me in this form are true and that false
information may lead to disqualification and dismissal if already in employment.
Signature:…………………………………….. Date:…………………………………….
FOR OFFICIAL USE ONLY
Recommendation of Panel:…………………………………………………………………………………
Position Offered:……………………………………………………………………………………………
Salary:………………………………………………………………………………………………………
Date of Appointment:………………………………………………………………………………………
