REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF FOREIGN AFFAIRS

MANILA
Diplomatic and Official Passport Section
PASSPORT APPLICATION
(TYPE OR PRINT LEGIBLY)
Name:

_____________________________________________________________________
(Last Name)

(First Name)

(Middle Name)

Date of Birth :

(PHOTO)

Place of Birth :

Sex :

Civil Status:

Fathers Name:
(If married, Name of Spouse)

Birth Place :

Address :

Mothers Name :

Telephone No.:

Birth Place :

Check if you are: Legitimate:

Illegitimate:

Citizenship Acquired By:

Election

Birth

Naturalization

Marriage ___________

PURPOSE OF TRAVEL

: _______________________________________________________________________

DESTINATION

: _______________________________________________________________________

OFFICE OF EMPLOYMENT

: _______________________________________________________________________

TELEPHONE NO.

: _______________________________________________________________________

DESIGNATION

: _______________________________________________________________________

HAVE YOU EVER BEEN ISSUED A PHILIPPINE PASSPORT?

YES ___________________ NO _____________________

If yes, Passport No. ____________________ Date and Place of Issue ______________________________________________

I SOLEMNLY SWEAR UNDER PENALTY OF LAW that the photograph attached is mine and
that the statements made on this Application Form are true and the attached documents are authentic.

(Signature of Applicant)
DO NOT FILL BELOW THIS LINE
Dipl/Offl. Ppt. No. :
Issued on

Valid Until

Remarks : __________________________________________
___________________________________________________
To be released upon submission of the following documents :

For Transmittal to :

1)
2)
3)

NV to

Processor

Date

____________________________
Printed name over signature

PLEASE READ REQUIREMENTS AT THE BACK

_____________________________
APPROVING OFFICER