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Form IEBC /ACOB01

Request for Accreditation for Election Observer Group to Observe the Electoral

Process

1. Election Observer Group Name:___________________________________________

2. Address:______________________________________________________________

3. Telephone: ____________________________________________________________

4. Principal Of�icers:

a. President/Chairperson:______________________________________________

b. Secretary General:__________________________________________________

c. Head of Mission (in the case of foreign diplomatic mission accredited to

Kenya):__________________________________________________________

5. Person authorized by the election observer group to liaise with the Commission at

HQ level:

Name: _______________________________________________________________

Position: ______________________________________________________________

Address: _________________________________________________________________

Telephone: ____________________________Email:_____________________________

6. Summary of the mission statement of the observer organization, including the

election activity(ies) it intends to observe (ATTACH MISSION STATEMENT)

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

________________________________________________________________________________

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7. Names and contact details for those persons authorized to represent the observer

group and liaise with the IEBC Regional Election Coordinators in each of the 17

regions:

Region Name Designation Contact details

(Phone, email, etc)

Nairobi

North Rift

Central Rift

Etc

8. Estimated number of observers that the observer group plans to deploy to observe

the process

9. PLEASE ATTACH SOURCE OF FUNDS ETC.

10. Person submitting this application:________________________________________________

11. Designation:__________________________________________________________________

12. Telephone, email, etc:__________________________________________________________

13. Statement of Commitment to the Code of Conduct for Election Observer

Groups by the Chairperson/Secretary General/Head of Diplomatic Mission

I,___________________________________________________________(name), Chairperson/Secretary

General/Head of Diplomatic Mission for _____________________________________________

(name of election observer group or foreign diplomatic mission accredited to Kenya)

hereby affirm that the nominated observers listed in Form IEBC/ACOB02 submitted

to the IEBC by our group, are the sole individuals that will receive the Identification

Cards or badges issued by the IEBC to the above mentioned observer group. The

identification cards or badges will be used only for the purpose of observing the

electoral process, at the location of assignment.

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I also affirm that the nominated observers shall adhere to the laws of Kenya, the

Code of Conduct for Election Observers, and such other instructions issued by the

Independent Electoral and Boundaries Commission.

Signature of Chairperson/Secretary General: _____________________________________________

Date: __________________________________________________________________________________________

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Form IEBC/ACOB02

Constituency: _________________________________________ Election Observer Group:__________________________________________

Name and telephone number of person submitting this list of observers: _______________________________________________________

(NB: This MUST be the person authorized by the election observer group Headquarters to liaise with the Regional Election Coordinator as per the approved Form IEBC/ACOB01)

List of Nominated Observers

No. Name Nationality Full Address National ID Number (Kenyan Observers) or Passport Number (International Observers)

Telephone

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Form IEBC /ACOB03

Declaration of Election Observer

I, _______________________________________________________ (name) hereby con�irm my commitment

to serve as an observer of ________________________________________________________________ (name of

election observer group or accredited foreign diplomatic mission in Kenya) to observe the

electoral process.

I shall adhere to the laws of Kenya, the Code of Conduct for Election Observers, and such

other instructions issued by the Independent Electoral and Boundaries Commission.

I understand that my accreditation may be revoked by the Independent Electoral and

Boundaries Commission if, among other reasons, it determines that I have infringed the

Code of Conduct for Electoral Observers.

Signature of Observer: ____________________________________ Date: ________________________________