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PANUNUMPA NG PROPESYONAL

Ako, s i

.______________________________

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(Pook na Sinifangan, Bayan/lungsod, Probinsya)

ay taimtim na nanunumlJa na itataguyod ko at ipagtatanggol ang Saligang Batas rig Pilipinas, na ako ay tunay na mananalig at tatalima rito; na susundin ko ang mga batas, mga utos na legal, at mga atas na ipinahayag ng mga sadyang itinakdang may kapangyarihan ng Republika ng Pilipinas; at kusa kong babalikatin ang pananagutang ito, na walang ana mang pasubali 0 hangaring umiwas. Taimtirn pa rin akong manunumpa na sa lahat ng panahon at pook na kinaroroonan ay mahigpit akong manghahawakan sa mga etikal at tuntuning propesyonal ng mga sa Piliplnas, at marapat kong gagampanan ng .

(Propes~------

buong husay sa abot ng aking makakaya ang mga tungkulin at pananagutang iniatang sa isang itinakdang -------;r;::~.:-:-:-:c--.---(PlfJpesyon)

Kasihan Nawa ako ng Diyos. (Lagda)

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(Kinuha sa)

(Big. ng Sedula)

(Petsa)

Nilagdaan at Pinanumpaan sa harap ko ngayong ika­ taon ng ating Panginoon

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sa

_ , Pilipinas.

FOR PRe PROCESSING

OK to Pay:

Selya DakLimentarya

.

_ (Pinunong Tagapanumpa)

OR No.: __ ._ _ Date Paid: Profession:

_

.

(Katungkulang Opisyal)

Registration No.:

Re~~s_lra_lio_n_O~:.:::le:...:: ==========-1 PERSONAL TeiephonefContact Number:

Dale of Examination:

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Cillzenship: Civil Slalus:

- - - - - - _... ­

DATA

Dale of Birth: Spouse's Name/Cilizenship:

Sex:

Father's Name/Cilizenship:

Mother's Name/Cilizenship

._----------_._---------------~----------------

.PLEASE FILL OUT THIS CLAIM SLIP

NAME: REGISTRATlmJ NO.

CLAIM SLIP ('-------------" ): PROFESSION: _

Please present this slip at Issuance Window __

REGISTRATiON DATE:- - - - - - - ­ _ _ _ to claim your professional Identification card oh

(NOTE: REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULD PRESENT SPECIAL POWER OF ATTORNEY I AUTHORIZATION LETTER FROM THE REGISTERED PROFESSIONAL). FOR CONFIRMATION PLEASE CALL UP (02) 736-22-48.

Registration Officer

C~__ PR_O_C_E_D_UR_E_S

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Step 1. Accomplish this Oath Form. Step 2. Pay for two sets of metered documentary stamps (one stamped Oil this form and one .for the Registration Certificate) at the Customer Service Center. Step 3. Present dUly accomplished oath form (where your profession belongs, for verification

of records and assessment at Window 14, Window'j 9, Window 28 or at PRC Service Center,

Ever-Recto

Step 4. Pay prescribed fees at the Cashier.

Step 5. Sign in the Registry Book and receive your claim slip at:

Window 17 Window 20 Window 27

Step 6. Claim your professional 10 as scheduled. Please refer to your claim slip for further instructions.

C

R_E_Q_U_'_R_E_M_E_N_:r_S

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1. Duly accomplished Oath Form or Panunumpa ng Propesyonal 2. Current Community Tax Certificate (cedula) 3. Two pieces passport size colored picture in white background with complete name tag (for Oath Form and Certificate of Registration) 4. One pc. 1"x1" colored picture in white background with complete name tag (for Registry of Profflssionals) . 5. Two sets of metered documentary stamps (for Oath Form and Certificate of Registration) 6. One (1) short brown envelope with name and profession

New registrants should come personally to the PRC Central Office or to the nearest Regional Office to file his/her application for registration and to affix his/her signature on the registry book. In case registrant is located abroad, please find below the following requirements: 1. Take the professional's oath before the Philippine Consul. 2. Special Power ofAttorney notarized by the Consul. 3. Copy of passport page showing personal data. 4. Copy of passport page showing date of entry abroad. Board Certificates shall be claimed at the Central Office or the Regional Office where the application for the same has been filed. Representatives must present,Special Power of Attorney and appropriate identification papers.

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, INITIAL REGISTRATION OF APPLICANTS LOCATED ABROAD

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THRU REPRESENTATIVE: I am enclosing herewith an oath form/Panunumpa ng Propesyonal for you to accomplish and please find below the rquirements for initial registration of applicants located abroad. - Take the professional's oath before the Philippine Consul.

- Special Power of Attorney notarized by the Consul.

- Copy of passport page showing personal data.

- Copy of passport page showing date of entry abroad.

/

Please follow the specifications for your pictures and the requirements listed at the back of the oath form.

PERLA D. SAYANA Chief, Registration Division