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Republic of the Philippines PRC REG Form No. 003 (Rev.

4/11/12)

RENEWAL Professional Regulation Commission


DUPLICATE Baguio City
CHANGE OF NAME/STATUS Paste here
REPRINT REGULATIONS DIVISION recent
PASSPORT
APPLICATION FOR PROFESSIONAL IDENTIFICATION CARD (PIC) SIZE colored
picture with
NAME: _ _ _, complete name
Last Name First Name Middle Name tag in white
background
PERMANENT ADDRESS: _ ZIP CODE: _

DATE FILED: _ _ PROFESSION: _ EXAM DATE: _ _


(mm/dd/yy) (mm/dd/yy)

REGISTRATION DATE: REGISTRATION NO: EXPIRATION DATE: _


(mm/dd/yy) (VALID UNTIL) (mm/dd/yy)
CITIZENSHIP: BIRTH DATE: _ E-MAIL/CELL NO./TEL NO. _ _
(mm/dd/yy)
This is to certify that all the information above are true and correct.
SIGNATURE OF LICENSEE

FOR PRC PROCESSING

YLP FROM: TO: P

SURCHARGE: Amount: OR No:


TOTAL AMOUNT: Date: Issued by:
ASSESSED BY:

PLEASE FILL THIS PORTION ID CLAIM SLIP


ISSUED BY: Date
NAME: AMOUNT PAID:
PROFESSION: OFFICIAL RECEIPT NO.:
REGISTRATION NO.: DATE PAID:
APPLICATION TYPE: ORIGINAL ID DUPLICATE REPRINT CHANGE OF NAME
To check if your PIC is ready for release , visit our website www.prcbaguio.blogspot.com for PIC availability (PICAV) or text 09219693919 (Smart) or
EMAIL us at prcbaguio.regulation@gmail.com. To claim your PIC, present this slip at the Releasing Section. For a representative, present this claim
slip, valid ID of the representative and authorization letter from the Professional. See also our schedule of mobile processing in your City/Town at our
WEBSITE www.prcbaguio.blogspot.com.

Republic of the Philippines PRC REG Form No. 003 (Rev. 4/11/12)

RENEWAL Professional Regulation Commission


DUPLICATE Baguio City
CHANGE OF NAME/STATUS Paste here
REPRINT REGULATIONS DIVISION recent
PASSPORT
APPLICATION FOR PROFESSIONAL IDENTIFICATION CARD (PIC) SIZE colored
picture with
NAME: _ _ _, _ _ _ complete name
Last Name First Name Middle Name tag in white
background
PERMANENT ADDRESS: _ ZIP CODE: _

DATE FILED: _ _ PROFESSION: _ EXAM DATE: _


(mm/dd/yy) (mm/dd/yy)

REGISTRATION DATE: REGISTRATION NO: EXPIRATION DATE: _


(mm/dd/yy) (VALID UNTIL) (mm/dd/yy)
CITIZENSHIP: BIRTH DATE: _ E-MAIL/CELL NO./TEL NO. _ _
(mm/dd/yy)
This is to certify that all the information above are true and correct.
SIGNATURE OF LICENSEE

FOR PRC PROCESSING


YLP FROM: TO:
P
SURCHARGE: Amount: OR No:
TOTAL AMOUNT: Date: Issued by:
ASSESSED BY:

ID CLAIM SLIP
PLEASE FILL THIS PORTION ISSUED BY: Date
NAME: AMOUNT PAID:
PROFESSION: OFFICIAL RECEIPT NO.:
REGISTRATION NO.: DATE PAID:
APPLICATION TYPE: ORIGINAL ID DUPLICATE REPRINT CHANGE OF NAME
To check if your PIC is ready for release , visit our website www.prcbaguio.blogspot.com for PIC availability (PICAV) or text 09219693919 (Smart) or
EMAIL us at prcbaguio.regulation@gmail.com. To claim your PIC, present this slip at the Releasing Section. For a representative, present this claim
slip, valid ID of the representative and authorization letter from the Professional. See also our schedule of mobile processing in your City/Town at our
WEBSITE www.prcbaguio.blogspot.com.
REQUIREMENTS
1. Duly accomplished Priority Slip Form.
2. One (1) copy RECENT passport-size colored picture in white background with complete nametag;
3. In case of loss of unexpired Professional Identification Card, submit duly notarized Affidavit of Loss;
4. Marriage certificate from NSO (in security paper) for married female applicants who wish to apply for change of name due to marriage;
5. For Petition for correction of name and/or date of birth, applicant submits copy of birth certificate from NSO in security paper (and NSO
marriage certificate for female married applicant) and duly notarized affidavit of explanation regarding request of correction ;
6. Certificate of membership or official receipt issued by Accredited Professional Organization as prescribed by respective boards (please
refer below);
7. If the Professional is abroad, he/she may renew his/her Professional Identification Card through a representative.

ADDITIONAL REQUIREMENT AS PRESCRIBED BY RESPECTIVE BOARDS


a. ARCHITECTS - UAP MEMBERSHIP ID/CERTIFICATION OF GOOD STANDING
b. CUSTOMS BROKER – CERTIFICATION OF GOOD STANDING FROM CCBI
c. ELECTRONICS ENGR/PROF. ELECTRONICS ENGR./ELECTRONICS TECHNICIAN -IECEP CERTIFICATION OF GOOD
STANDING
d. GEODETIC ENGINEER. - G.E.P. MEMBERSHIP ID/CERTIFICATION OF GOOD STANDING
e. GUIDANCE AND COUNSELING –VALID CERTIFICATE OF PGCA MEMBERSHIP AND ANNUAL PAYMENT RECEIPTS
f. MECHANICAL ENGR/PROF. MECHANICAL ENGR/CERTIFIED PLANT MECHANIC – CERTIFICATION OF GOOD STANDING
FROM PHILIPPINE SOCIETY OF MECHANICAL ENGINEERS holding office at Don Lorenzo Bldg., P. Paredes St., Sampaloc,
Manila and its duly accredited regional chapters
g. PROF. AGRI. ENGRS. – FILL-UP DATA FORM AND SUBMIT PSAE ID/CERTIFICATION OF GOOD STANDING
h. REGISTERED ELECTRICAL ENGRS./RME/PEE - IIEE MEMBERSHIP ID/CERTIFICATION OF GOOD STANDING

PROCEDURE
Step 1 - Secure priority slip form from the Public Assistance and Complaint Desk (PACD); or download renewal form at prcbaguio.blogspot.com;
Step 2 - Accomplish priority slip form and paste the picture, if no picture proceed to Customer Service Center, then proceed to Counter 9 for
assessment of fees and evaluation of requirements;
Step 3 - Pay the assessed fee;
Step 4 - Renewal Officer issues claim slip.

Note: To claim ID, present this claim slip at the Releasing Section. For representative present claim slip, authorization letter from the
Professional, and valid ID with picture and signature.

As the authorized representative, I assume direct and full responsibility/liability for the professional ID card
released to me. Attached is my authorization signed by the licensee.

_______________________________________________________________
Signature over Printed Name of REPRESENTATIVE

REQUIREMENTS
1. Duly accomplished Priority Slip Form.
2. One (1) copy RECENT passport-size colored picture in white background with complete nametag;
3. In case of loss of unexpired Professional Identification Card, submit duly notarized Affidavit of Loss;
4. Marriage certificate from NSO (in security paper) for married female applicants who wish to apply for change of name due to marriage;
5. For Petition for correction of name and/or date of birth, applicant submits copy of birth certificate from NSO in security paper (and NSO
marriage certificate for female married applicant) and duly notarized affidavit of explanation regarding request of correction;
6. Certificate of membership or official receipt issued by accredited professional organization as prescribed by respective boards (please
refer below);
7. If the Professional is abroad, he/she may renew his/her Professional Identification Card through a representative.

ADDITIONAL REQUIREMENT AS PRESCRIBED BY RESPECTIVE BOARDS


a. ARCHITECTS - UAP MEMBERSHIP ID/CERTIFICATION OF GOOD STANDING
b. CUSTOMS BROKER – CERTIFICATION OF GOOD STANDING FROM CCBI
c. ELECTRONICS ENGR/PROF. ELECTRONICS ENGR./ELECTRONICS TECHNICIAN -IECEP CERTIFICATION OF GOOD
STANDING
d. GEODETIC ENGINEER. - G.E.P. MEMBERSHIP ID/CERTIFICATION OF GOOD STANDING
e. GUIDANCE AND COUNSELING –VALID CERTIFICATE OF PGCA MEMBERSHIP AND ANNUAL PAYMENT RECEIPTS
f. MECHANICAL ENGR/PROF. MECHANICAL ENGR/CERTIFIED PLANT MECHANIC – CERTIFICATION OF GOOD STANDING
FROM PHILIPPINE SOCIETY OF MECHANICAL ENGINEERS holding office at Don Lorenzo Bldg., P. Paredes St., Sampaloc,
Manila and its duly accredited regional chapters
g. PROF. AGRI. ENGRS. – FILL-UP DATA FORM AND SUBMIT PSAE ID/CERTIFICATION OF GOOD STANDING
h. REGISTERED ELECTRICAL ENGRS./RME/PEE - IIEE MEMBERSHIP ID/CERTIFICATION OF GOOD STANDING

PROCEDURE
Step 1 - Secure priority slip form from the Public Assistance and Complaint Desk (PACD); or download renewal form at prcbaguio.blogspot.com;
Step 2 - Accomplish priority slip form and paste the picture, if no picture proceed to Customer Service Center, then proceed to Counter 9 for
assessment of fees and evaluation of requirements;
Step 3 - Pay the assessed fee;
Step 4 - Renewal Officer issues claim slip.

Note: To claim ID, present this claim slip at the Releasing Section. For representative, present claim slip, authorization letter from the
Professional, and valid ID with picture and signature.

As the authorized representative, I assume direct and full responsibility/liability for the professional ID
card released to me. Attached is my authorization signed by the licensee.

________________________________________________________________
Signature over Printed Name of REPRESENTATIVE