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Appform Passport

Chief:

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67 views

Appform Passport

Chief:

Uploaded by

bibiboy1218
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

DEPARTMENT OF FOREIGN AFFAIRS


PASSPORT APPLICATION FORM
THIS APPLICATION FORM IS NOT FOR SALE. PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE NIA IF NOT APPLICABLE. PROVIDING FALSE
STATEMENTS IN PASSPORT APPLICATIONS IS PUNISHABLE BY LAW (R.A. 8239).

LAST NAME/ APELYIDO FIRST NAME/ PANGALAN (Jr.Ill/Ill)

MIDDLE NAME / GITNANG PANGALAN PLACE OF BIRTH/ POOK NG KAPANGANAKAN

_______,! ____ / ____ GENDER / KASARIAN DMALE DFEMALE


Month Day Year
DATE OF BIRTH/ PETSA NG KAPANGANAKAN
(Ex.: March 8, 2010)

Civil Status: DSingle DMarried DWidow/er D Legally Separated D Annulled


Complete Address: ___________________ Tel. No.:_______
Present Occupation: ___________________ Mobile No.: ______
Work Address: _______ ______________ Tel. No.:_____ __
E-mail Address: ------------------------------
Name of Wife I Husband: __________________ Citizenship: ______
Name of Father: Citizenship: ______
Maiden/ Single name of Mother: Citizenship: ______
Citizenship Acquired By:
DBirth DElection DMarriage DNaturalization DR.A. 9225 DOthers
Are you a holder of a foreign passport? DYes DNo Have you ever been issued a Philippine Passport? □ Yes □ No
If Yes, from what country? If Yes, latest Passport Number?
Date of issue: Place of issue:
(For applicants below 18 years old ONLY)
Name of minor's travelling companion:
Companion's relationship: Contact Number:

I SOLEMNLY SWEAR that 1) I am a Filipino citizen. 2) The information I provided in this application are true and
correct. 3) The supporting documents attached are authentic. 4) I am aware that under the law, I am allowed to hold only one
Philippine passport at any given time. 5) I am aware that making false statements in passport application, furnishing falsified or
forged documents in support thereof are punishable by law.
Signature of Applicant or Legal Guardian (for minor applicants)

FOR USE OF THE DEPARTMENT OF FOREIGN AFFAIRS ONLY. PLEASE DO NOT WRITE BELOW THIS LINE.

REMARKS:
.,I

Processor: Encoder: Si<minq Officer: Transmission Officer:


RECEIVED CANCELLED PASSPORT: RECEIVED NEW PASSPORT:
I
FOR ADMINISTRATIVE USE ONLY:

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