Philippines - Passport Application

PHILIPPINE CONSULATE GENERAL Geneva, Switzerland

PASSPORT APPLICATION For Official Use Only New Passport No. __________ O.R. No. ________ Service No. ________ Date: ____________________ PLEASE FILL IN ALL BLANKS AND TYPE OR PRINT LEGIBLY. SURNAME :_____________________________________ GIVEN NAME :_____________________________________ MIDDLE NAME/MAIDEN NAME :_____________________________________ DATE OF BIRTH :___________________________________________________ PLACE OF BIRTH :___________________________________________________ SEX

:

Male

CIVIL STATUS Name of spouse, if married NAME OF FATHER NAME OF MOTHER ADDRESS IN PHILIPPINES Telephone Number FOREIGN/MAILING ADDRESS Telephone Number IMMIGRATION STATUS OCCUPATION OFFICE OF EMPLOYMENT Address/Telephone Number CHECK IF YOU ARE

: Single Married Widowed/er Separated Divorced :______________________ Citizenship: __________________ :______________________ Citizenship: __________________ :______________________ Citizenship: __________________ :___________________________________________________ :___________________________________________________ :___________________________________________________ :___________________________________________________ : Contract Worker Seaman Others : __________________________________________________ :___________________________________________________ :___________________________________________________ : Legitimate Illegitimate

CITIZENSHIP ACQUIRED BY

:

Birth

Female

Naturalization

HAVE YOU EVER BEEN ISSUED A PHILIPPINE PASSPORT?

Election

Marriage

Yes

No

LATEST PASSPORT NUMBER :___________________________________________________ Place of Issue:______________________________________ Date Issued: ______________ HAVE YOU ACQUIRED FOREIGN CITIZENSHIP? ARE YOU A GOVERNMENT EMPLOYEE?

Yes Yes

No No

PERSONS TO BE NOTIFIED IN CASE OF ACCIDENT OR DEATH: (Philippines) Name:_____________________________________________________________ Address:______________________________________ Telephone:________________ (Abroad) Name:_____________________________________________________________ Address:______________________________________ Telephone:________________ I solemnly swear that the above attached photograph is mine, that the statements made on this Application Form are true and the attached supporting documents are authentic.

________________________ Signature of Applicant

Left Thumbmark

Right Tumbmark

_______________________ Signing Officer

Received by: