Republic of the Philippines

Department of National Defense

PHILIPPINE VETERANS AFFAIRS OFFICE
Camp General Emilio Aguinaldo
Quezon City

IDENTITY SHEET
INSTRUCTIONS: To facilitate the early processing of your claim for Old Age Pension under
RA 6948, as amended by R.A.7696, please carefully accomplish and supply the required
information to establish your
identity and return the same to this office together with your application

1. FULL NAME OF VETERAN __________________________________________________________

(Last Name) (First Name)
(Middle Name)
2. Date and Place of Birth Veteran _________________________________________________________

3. FULL NAME OF SPOUSE/WIDOW ____________________________________________________

(Last Name) (First Name)
(Middle Name)
4. Date and Place of Birth
Spouse/Widow____________________________________________________

5. Date and Place of Marriage _________________ ___________________________________________

6. Rank and Army Serial Number

7. Organization (Specific Unit) ___________________________________________________________

8. FULL NAME OF Veteran’s Mother _____________________________________________________

9. FULL NAME OF Veteran’s Father ______________________________________________________

10. FULL NAME OF Spouse’s/Widow’s Mother_______________________________________________

10. FULL NAME OF Spouse’s/Widow’s Father _______________________________________________

Date of Birth Place of Birth

12 Name of Children ____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

13. Present Address of CLAIMANT ________________________________________________________

I hereby certify to the best of my knowledge that the foregoing information are
true and correct.

THUMBMARKS
__________________________
Signature of Veteran/Claimant
Over Printed
Name

LEFT RIGHT
 SUBSCRIBED AND SWORN to before me this _______________ day of
____________________
2001 at ____________________________________

____________________________
Administering Officer

Republic of the Philippines

Department of National Defense
PHILIPPINE VETERANS AFFAIRS OFFICE
Camp General Emilio Aguinaldo
Quezon City

IDENTITY SHEET
INSTRUCTIONS: To facilitate the early processing of your claim for Old Age Pension under RA
6948, as
amended by R.A.7696, please carefully accomplish and supply the required information to
establish your
identity and return the same to this office together with your application

1. FULL NAME OF VETERAN __________________________________________________________

(Last Name) (First Name) (Middle
Name)
2. Date and Place of Birth Veteran _________________________________________________________

3. FULL NAME OF SPOUSE/WIDOW ____________________________________________________

(Last Name) (First Name) (Middle
Name)
4. Date and Place of Birth Spouse/Widow____________________________________________________

5. Date and Place of Marriage _________________ ___________________________________________

6. Rank and Army Serial Number

7. Organization (Specific Unit) ___________________________________________________________

8. FULL NAME OF Veteran’s Mother _____________________________________________________

9. FULL NAME OF Veteran’s Father ______________________________________________________

10. FULL NAME OF Spouse’s/Widow’s Mother_______________________________________________

10. FULL NAME OF Spouse’s/Widow’s Father _______________________________________________

Date of Birth Place of Birth

12 Name of Children ____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

13. Present Address of CLAIMANT ________________________________________________________

I hereby certify to the best of my knowledge that the foregoing information are true
and correct.

THUMBMARKS
__________________________
Signature of Veteran/Claimant
Over Printed
Name
 LEFT RIGHT

SUBSCRIBED AND SWORN to before me this _____________ day of ____________________

2001 at ____________________________________

____________________________
Administering Officer