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F A Form No. 2 (Revised 1981) : ‘Attach one Signed (2" x2") Photograph taken withi last 6 months with Signature on front side Consulate General Republic of the Philippines, Mumbai, India Application for Non-Immigrant Visa Surname Firet Name Miadle Name Ser Onaie Oremate Date of Birth ‘Chizenship Place of Birth Civil Status Disinge =D] Married W married, stale.name and Address of spouse Owidowed Dseparated [1 divorced ‘Applicants Address Since Occupation Since peer Support Names and ages of children Father's Name Mothers Name Description of Travel Document Tre No. Date of Issue Issued by Valid Untit Other persons traveling to the Philippines with applicant under the same travel documents or under Separate travel documents Port of Entry Purpose of Entry Length of Stay Address in the Philippines Reference in the Philippines Name Address Destination after the Philippines (See overleat) Documents offered for Inspection : (include two photostat or attested copies of the relevant documents to support the application, original documents should be presented for verification) Were you ever refused any kind of visa, denied admission into or deported /removed at government expense from the Philippines? O Wo 1 ¥6s (state circumstances) | understand that | may only enter the Philippines at a Port of Entry designated by the Philippine immigration Authorities and with the permission of and under the conditions, including the ghving of bond, imposed by those ‘authorities, | solemnly swear that the foregoing statements are true to the best of my knowledge and belie (Signature of Applicant) (Date) ‘Subscribed and sworn to before me this___day of ____200__ Consul General of the Republic of the Philippines (For Official Use Only) VisaNo.__________ Granted on 200 as_nonimmigrant under section 9( _) of Philippines Immigration Act. of 1940, as ammended. valid. until 200 Visa includes Remarks, It any, Look out a Consul General of the Republic of the Foes paid____O.R. No. Ser. No. Philippines