Republic of the Philippines

Consulate General of the Philippines

Toronto, ON, Canada
CITIZENSHIP RETENTION and RE-ACQUISITION ACT of 2003 (R. A. 9225)

Petitioner:
(Signature over Printed Name)
Nationality: Date of Birth:

CHECK LIST OF REQUIREMENTS

(Pursuant to the Revised Rules (Memo. No. AFF-05-002) Governing Philippine Citizenship
under Republic Act No. 9225, which took effect on 1 November 2005)
Petition must be completely accomplished and sign. Print all information LEGIBLY. Do not leave any space blank.
Indicate “N/A” if not applicable. Petition not properly accomplished will not be acted upon.
Duly Accomplished Verified Petition (Application form for Dual Citizenship)
Three (3) recent 2”x2” photographs (colored with WHITE background)
ONE(1) ORIGINAL & TWO (2) CLEAR AND LEGIBLE PHOTOCOPIES OF THE FOLLOWING MUST BE
SUBMITTED:
Proof as natural-born Philippine Citizen:
Birth Certificate on security paper (SECPA) issued by the Philippine Statistics Authority (PSA,
formerly known as NSO). To secure online, visit www.psaserbilis.com.ph. This you will also use in
applying for a Philippine passport.
Old Philippine passport (if lost, Execute Affidavit of Lost Form)
Marriage Certificate on security paper (SECPA)(for married applicant)
Death Certificate of spouse (if applicable)
Appropriate Philippine Court Order on the annulment of marriage or recognition of divorce (if applicable)
Canadian / foreign passport
Canadian / foreign Citizenship Card/ID or Certificate of Oath Taking as a Canadian (to secure proof of your
Canadian citizenship visit http:// www.cic.gc.ca/english/information/applications/certif.asp)
Fee of C$72.50/applicant (Credit/Debit Card, Money Order or Bank draft payable to Philippine Consulate
General)

Additional Requirements for BI-registered applicants:

Original Alien Certificate of Registration (ACR)
Original Immigrant Certificate of Residence (ICR) or Certificate of Residence for Temporary Visitor (CRTV)
Philippine Voter’s Affidavit
OTHER SUPPORTING DOCUMENTS:
Certificate of Non-availability of Birth Record Original Birth Certificate of siblings issued by
(if born before 1950) from the Local Civil Registrar the Philippine Statistics Authority (PSA)
or from PSA Order of Adoption, if applicable
Baptismal Certificate/Joint Birth Affidavit Other documents as may be required
Marriage Certificate of parents
IF WITH DEPENDENT/S, THE FOLLOWING ARE REQUIRED FOR EACH DEPENDENT:
Completed and signed Dual Citizenship Supplement for dependent
Original Birth Certificate authenticated by the Philippine Statistics Authority (PSA) if born in the
Philippines or Statement of Live Birth (Form 2) or Report of Birth if born in Canada (to secure online visit:
www.ontario.ca/government/birth-certificates).
Two (2) recent 2”X2” photographs (colored with WHITE background).
Canadian / foreign Citizenship Card/ID
Canadian / foreign passport
Fee of C$36.25 per dependent
CONSULATE GENERAL OF THE PHILIPPINES I.C. NO. ISSUED
TORONTO TO-
APPLICATION FORM FOR CITIZENSHIP RETENTION AND REACQUISITION
(under R.A. 9225)

Affix colored ID photograph Affix colored ID photograph Affix colored ID photograph

(sized 2" x 2") with white (sized 2" x 2") with white (sized 2" x 2") with white
background. background. background.
Photograph must be taken Photograph must be taken Photograph must be taken
within the last three months within the last three months within the last three months
from the date of application. from the date of application. from the date of application.
Subject must not wear Subject must not wear Subject must not wear
eyewear (e.g. eyeglasses, eyewear (e.g. eyeglasses, eyewear (e.g. eyeglasses,
sunglasses, colored sunglasses, colored sunglasses, colored
contacts) or headwear. contacts) or headwear. contacts) or headwear.

Print all information legibly. Do not leave spaces blank. Indicate "N/A," "NONE," or "DO NOT KNOW' as appropriate.
Mark appropriate box with ” ”.

I. PERSONAL DATA
1. Last Name: _________________________________________________________________
First Name: _________________________________________________________________
Middle Name1: _______________________________________________________________
2. Birthdate: ______________________ 3. Place of Birth: ______________________________
4. Civil Status: Single Married Divorced 5. Sex: Male
Widow Legally Separated Female
6. Nationality: _______________ 7. Height (Meters): ____________ 8. Weight (kg) ___________
9. Permanent Philippine Address: __________________________________________________
____________________________________________________________________________
10. Address Abroad: _____________________________________________________________
___________________________________________________________________________
11. Phone No.: _________________________ 12 Mobile No.: ___________________________
13 Email Address: ______________________________________________________________
14. Name of Spouse: _____________________15. Nationality: ___________________________
16. Applicant’s Father’s name: _____________________________________________________
17. Father’s Nationality: ___________________18. Father’s Birthday: ______________________
19. Applicant’s Mother’s Name: _____________________________________________________
20. Mother’s Nationality: __________________ 21. Mother’s Birthday: ______________________

II. FOREIGN CITIZENSHIP

22. Current Foreign Citizenship: ______________Mode of Acquisition: _____________________
23. Date of Acquisition: _____________________Naturalization Certificate No.:_______________
24 Foreign Passport No.: ___________________ Date & Place of Issue.: ____________________

III. UNMARRIED CHILDREN AGED BELOW 18 INCLUDED AS DEPENDENTS IN THIS PETITION.

Name Relationship Date of Birth Age

____________________________
1 Mother’s Maiden Name, for unmarried applicants.
CERTIFICATION

I hereby certify under oath that all the information in this general application form, consisting of two pages,
including this page on which this Certification is written, are true and correct information about myself as an
applicant. I further warrant that I have complied with all the requirements of the Philippine Consulate General in
Toronto, Canada and the Bureau of Immigration with respect to my application for the issuance of an
Identification Certificate (1.C.) and that I submitted duly certified copies of documents issued under the official seal
of the officer having legal custody of their originals in the Philippines and foreign documents with their official
translation in English duly authenticated by the consular official in the Foreign Service of the Philippines in the
foreign country in compliance with the requirements of the Bureau of Immigration. I understand that my
application will not be processed by the Bureau if it finds any statement herein to be false, if any document
submitted is found to have been falsified, or if I fail to comply with all the requirements of the Bureau of
Immigration with respect to my application/petition without prejudice to whatever action(s) the Philippine
Consulate General in Toronto, Canada or the Bureau of Immigration shall take in accordance with applicable
laws of the Republic of the Philippines.

Date Executed:
Place Executed: Toronto, Ontario, Canada

(Applicant's Signature over Printed Name)

Consular Section )
Philippine Consulate General) S.S.
Toronto, Canada )

SUBSCRIBED AND SWORN to before me this day of ____________________ 20_ _ at

Toronto, Ontario, Canada.

Consular Officer

Doc. No.:
Page No.:
Book No.:
Series of 20
0. R. No.:
Service No.:
Fee Paid: C$
AFFIDAVIT OF LOSS OF PHILIPPINE PASSPORT

I, ,a citizen, of legal age,

 single (never been married) /  married /  separated /  annulled /  divorced, and presently residing at
, after having been
sworn to in accordance with law, do hereby depose and say, that:
1. The following are my TRUE AND REAL birth and personal data as appearing on my RECENTLY ISSUED Philippine passport:
Last Name
First Name
Middle Name
Date of Birth
Place of Birth
2. I am the holder of a Philippine passport with the following data:
Passport Number
Date of Issue
Date of Expiry
Place of Issue

3. The aforementioned Philippine passport was lost on at approximately

am/pm, due to the following circumstances: (please narrate the circumstances leading to the loss of your passport)

;
4. Said passport was lost due to the foregoing circumstances and not through negligence, with willful intent or for any ulterior motive
on my part;
5. Ernest efforts have been exerted to recover my passport, but to no avail;
6. I am executing this Affidavit in support of my application for Re-acquisition and Retention of Philippine Citizenship; and,
7. I attest to the veracity of the foregoing information.
IN WITNESS WHEREOF, I hereby sign this Affidavit on in Toronto, ON, Canada.

Printed Name and Signature

CONSULATE GENERAL OF THE PHILIPPINES )

CONSULAR SECTION ) SS
TORONTO, ONTARIO )

SUBSCRIBED AND SWORN TO before me on at the Consulate General of the Philippines, Toronto,
Ontario, Canada.