Kpa Port Pass Form PDF Details

Are you looking for a simple and efficient way to access service information, track data, and view customer details? Then KPA's Port Pass Form is the perfect solution for your organization. This form provides an easy-to-use interface that allows users to quickly access the necessary tools needed to submit their port pass requests effortlessly. With this form and its many features such as commitment of safety, privacy protection, electronic signature capability, ease of use, fast response time and integration with existing systems; all your logistics needs will be fulfilled efficiently. Keep reading to learn more about how this powerful system can help simplify your operations!

Form NameKpa Port Pass Form
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other nameskifwa movement pass application form, kpa port pass form, port pass application, portpass application form

Form Preview Example


Please select one of the Port Movement Card types:


First Name:

(please circle)



Date of Birth:



Telephone Number (Include Country Code):

Port Movement/Access Card Application Form

Applications must be completed in NEAT AND LEGIBLE hand writing and in black or blue ink

All completed application forms should be returned to the KPA Port Pass Office located at the KPA Headquarters, Operations Block

Please allow 3 5 working days before checking on the status of your application on +254 41 211 32 69

KPA Employee

Government Agency

Port User

KPA Contractor



Middle Name:


Last Name:













Postal Address:


Postal Code:











Email Address:




Mobile Number (Include Country Code):



Physical Residential Address (Include Name of Road, Street & Estate /Mtaa):





Have you ever applied received a KPA Movement/Access Card? YES/ NO (please circle)

If yes, please provide the Card No.:










Issuing Authority:



Country of Issue:



Date of Issue:




















Job Description:



Reason Access is requested:







Employer Address (Postal)





Postal Code:


Do you have a Vehicle? YES/NO (please circle)








Own Vehicle

Hired Vehicle


If yes please provide Reg. No.









AUTHORISING PERSON AT PARENT COMPANY (applications without signature WILL NOT be processed)




Contact Number:

Declaration (to be signed by applicant)

1.I declare that the information contained within this application and any attachments is true and correct and that if I willingly omit or provide information that is false I will be denied access to all KPA facilities and KPA can initiate legal action against me.

2.I have read and understood the attached regulations relating to KPA Movement/Access Card use on page 2 of this document.

3.KPA reserves the right to restrict or deny access to any KPA facility if operational needs of access cannot be established by the applicant




Signature: ___________________________ _________________________________ Date: _____/______/______


Application received: ______________

Input By : ____________________ KPA Movement/Access Card No. : ______________________

Access Group: ____________________ Access Privileges (Controlled or Restricted): ______________________Date of Issue:












Form R13


1.Cards MUST BE DISPLAYED AT ALL TIMES while in the Port Facility. Cards cannot be shared or borrowed.

2.Any lost cards are to be reported immediately to KPA Security +254 721 970 440. Lost cards can be replaced at a fee and on producing a valid Kenya Police Services Abstract.

3.Cards MUST BE USED at all times to enter and exit the Port Facility.

4.Users MUST USE their card every time they enter and exit the port, even if they are a passenger in a vehicle.

5.Vehicles must enter the access gate area ONE AT A TIME.

6.Pedestrians MUST ENTER the Port Facility using PEDESTRIAN ACCESS GATES and keep to designated walkways within the Port Facility.

7.Any person who does not have a KPA Movement/Access Card and wishes to enter the Port Facility MUST make prior arrangements with the Port Security Office and give 48 HOURS notice to facilitate his/her registration of a Port Movement/Access Card as required.

8.No person shall be authorized to access the port unless they are engaged in legitimate port related business.

9.You must only access the port with the KPA Movement/Access card associated to the parent company on whose behalf you are employed and for the purpose stated thereof by your employer as reason access is required in the application form R13. Should you engage in any other business other than what is stated, YOU AND YOUR employer shall be held fully accountable and this will result but not limited to having your ACCESS CARD


10.The KPA Movement/Access Card remains the property of KPA and it can be withdrawn by the issuing authority without any notice and whenever deemed necessary.


Any person failing to comply with the condition of entry and proximity card usage will have their access rights from the port area withdrawn.

Kenya Ports Authority constantly monitors its Port Facilities 24HRS via security cameras.

Footage taken from camera operations is compliant for use as court evidence.

Breaches of the above conditions constitute Criminal Offences under the Constitution of Kenya and prosecution under the Laws therein may follow.

Fines of up to KES.50,000.00 apply for non-compliance with Port Security requirements.

Derek Hagstrom

Port Security Officer

May 2012

How to Edit Kpa Port Pass Form Online for Free

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Step 2: When you launch the PDF editor, you will find the form all set to be filled out. Aside from filling out different fields, you may also do many other actions with the form, namely putting on any textual content, changing the initial text, inserting graphics, placing your signature to the document, and much more.

This form will require particular data to be filled in, hence be certain to take the time to fill in precisely what is requested:

1. While filling out the kpa port pass application form, be certain to incorporate all of the important blank fields in the associated part. It will help speed up the work, which allows your details to be processed promptly and appropriately.

Find out how to fill in portpass application form stage 1

2. The next step is usually to fill in all of the following blanks: Name, Signature, Declaration to be signed by, Position, Contact Number, I declare that the information, information that is false I will, I have read and understood the, KPA reserves the right to, PAUMENT METHOD, PAYMENT METHOD Signature, Date, OFFICE USE ONLY Application, Input By KPA Movem entAccess, and Access Group Access Privileges.

Stage number 2 in submitting portpass application form

People often make some errors when completing Declaration to be signed by in this area. Ensure that you double-check whatever you type in here.

Step 3: Check what you have typed into the form fields and click on the "Done" button. Go for a 7-day free trial plan with us and acquire instant access to kpa port pass application form - accessible inside your personal cabinet. We don't share the information that you type in while working with documents at our site.