Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Attach your 2 x 2 colored photograph with white background using permanent glue in the photograph box. The photograph must be taken within the last six (6) months to reflect your current appearance. Scanned photographs are not allowed.
Present Immigration Status Address Abroad Last Day of Authorized Stay [mm-dd-yyyy]
No. Street, Subdivision, Village, City, State, Country, Zip Code
Method of Application
Personal Accreditation Number Authorized Representative Contact Number
Email Address
Middle Name
Middle Name
Country of Birth
Citizenship / Nationality
Civil Status
Weight (kg)
[ IF ACR I-CARD IS CLAIMED BY OTHER PERSON, PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS ]
AEP Number
Registration Number
[mm-dd-yyyy]
Contact Number
Reviewed by:
Approved by:
C E RT I F IC AT ION
I HEREBY CERTIFY under oath that: (1) All the information in the foregoing application is truthful, complete and correct; (2) I submitted authentic documents. I understand that my application can be summarily denied by the Bureau if: (1) It nds any statement herein to be false; (2) Any document submitted are found to have been falsi ed or; (3) I fail to comply with all the requirements with respect to my application / petition without prejudice to whatever action the Bureau of Immigration shall take in accordance with applicable laws of the Republic of the Philippines. Date: _____________ Petitioner Signature over Printed Name Republic of the Philippines) City/ Municipality of_________) S.S. Subscribe and sworn to before me this_____day of _____________________,_____affiant exhibiting his / her ACR, Passport number________________________________ issued at ______________________________ on ________________________ . Doc. No. Book No. Page No. Series of. Applicant Signature over Printed Name
Name of Authorized Representative Accreditated Travel Agency / Law O ce BI Accreditation Number Contact Number
Claimant: