Community / Village Agreement

Reference No.: (To be assigned by Chief's office) Date Submitted:

Part A — Parties to This Agreement

First Party (Full Name):

National ID / Passport No.:

Phone Number:

Residential Address / Village / Sub-Location:

Second Party (Full Name):

National ID / Passport No.:

Phone Number:

Residential Address / Village / Sub-Location:

Third Party / Additional Party (if applicable):

Part B — Subject Matter

Community / Village Name:

Subject / Purpose of Agreement:

Description of Agreed Terms:

Part C — General Terms & Conditions

1. Both parties confirm that they enter into this agreement freely and voluntarily, without coercion or duress.

2. Both parties declare that the information provided herein is true and correct to the best of their knowledge.

3. Any disputes arising from this agreement shall first be referred to the Chief's office for mediation before any other forum.

4. This agreement shall be governed by the laws of Kenya.

5. Any amendments to this agreement must be made in writing and witnessed by the Chief or an authorised officer.

Special Conditions (if any):

Part D — Signatures

First Party

Signature & Date:

Full Name (Print): ________________________

Second Party

Signature & Date:

Full Name (Print): ________________________

Third Party (if applicable)

Signature & Date:

Fourth Party (if applicable)

Signature & Date:

FOR OFFICIAL USE ONLY — Chief's Office

Chief's Name:

Location:

Date Witnessed:

System Reference No.:

Chief's Signature:

Official Stamp:

STAMP HERE

Notes / Observations:

Republic of Kenya

National Government Administration