THIRD SCHEDULE

I/We, the undersigned,

(Here, identify in general terms, who the petitioner or petitioners are, for example, citizens of Kenya, residents of province or region, workers of industry, etc.)

DRAW the attention of the Assembly to the following:

(Here, briefly state the reasons underlying the request for the intervention of the Assembly by outlining the grievances or problems by summarizing the facts which the petitioner or petitioners wish the Assembly to consider.)

THAT
[Here confirm that efforts have been made to have the matter addressed by the relevant body, and it failed to give satisfactory response.]

THAT
[Here confirm that the issues in respect of which the petition is made are not pending before any court of law, or constitutional or legal body.]

HEREFORE your humble petitioner(s) Pray that Assembly—

(Here, set out the prayer by stating in summary what action the petitioners wish Assembly to take or refrain from.)

Name of petitioner Full Address National ID. or Passport No. Signature/Thumb impression

........... ............... ................ ....................

........... ............... ................ ....................

........... ............... ................ ....................

(Here, repeat the summary in first page)

Name of petitioner Signature/Thumb impression

................................................... ...................................................
................................................... ...................................................
................................................... ...................................................

(Subsequent Pages)

* This form may contain such variations as the circumstances of each case may require.