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Important Reminders

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Your appointment is on Fri, Jul 04, 2014 at 02:00 pm.
Please be at DFA- NCR Central (Robinsons Galleria) by 02:00 pm.
Please make sure you have prepared all the requirements.
You can view the list at www.galleria.passport.com.ph
Please make sure to photocopy all of your requirements.
Applicants without a complete set of photocopies will not be entertained.
For your NSO certificate requirements, you may call (02) 737-1111.
Nationwide delivery within 3-4 days.
You may have your passport delivered for extra convenience.
Please prepare extra P120 for the delivery fee.
Please print this page and the application form on LONG BOND PAPER.
Applicants without the printed application form will not be allowed entry at the DFA.
Please complete the application form before going to the DFA.
For questions or concerns, you may email info@passport.com.ph.
Thank you for using the DFA Passport Appointment System.
REPUBLC OF THE PHLPPNES
DEPARTMENT OF FOREIGN AFFAIRS
MANLA
E-PASSPORT APPLICATION
PLEASE PROVDE CORRECT NFORMATON AND DO NOT LEAVE SPACES BLANK
LAST NAME / APELYDO
MDDLE NAME / GTNANG PANGALAN
DATE OF BRTH (Ex. Day/Month/Year)
FRST NAME / PANGALAN (Jr. / / )
PLACE OF BRTH / POOK NG KAPANGANAKAN
GENDER / KASARAN
Civil Status: Single Married Widow/er Legally Separated Annulled
Name of Wife / Husband: Citizenship:
Complete Address: Tel. No:
Present Occupation: Mobile No:
Work Address:
Email Address: Office No:
Name of Father: Citizenship:
Maiden/Single Name of
Mother:
Citizenship:
Citizenship Acquired By:
Birth Election Marriage Naturalization
R.A.9225 Others: ________________________
Purpose of Travel:
Tour Seaman Business Migration
Study Work Others: ______________
Are you a holder of a foreign passport?
Yes No
f Yes, from what country? ___________________
Have you ever been issued a Philippine Passport?
Yes No
f Yes, latest passport number? _______________
Date of issue ________ Place of issue _________
SOLEMNLY SWEAR that 1) am a Filipino citizen. 2) The information provided in this application is true and correct. 3) The supporting
documents attached are authentic. 4) have not been issued a passport under any other name. 5) am aware that under the law, am
allowed to hold only one Philippine passport at any given time. 6) am aware that making false statements in passport application furnishing
falsified or forged documents in support thereof are punishable by law.
FOR STRCT COMPLANCE: Please print name and affix initials.
Processor: Encoder: Signing Officer:
RECEVED CANCELLED PASSPORT: RECEVED NEW PASSPORT:
FOR ADMNSTRATVE USE ONLY:
Name of Wife / Husband: Citizenship:
Complete Address: Tel. No:
Present Occupation: Mobile No:
Work Address:
Email Address: Office No:
( For appIicants beIow 18 years oId ONLY )
Name of minor's travelling companion:
Companion's relationship:
Contact Number:
Signature of Applicant or Legal Guardian (for minor applicants)
FOR USE OF THE DEPARTMENT OF FOREGN AFFARS ONLY. PLEASE DO NOT WRTE BELOW THS LNE
REMARKS:
Fri, Jul 04, 2014 02:00 pm
CHELSEA LOUISE JAN
PENERA
EUSEBIO
FEMALE 05/SEP/1995
MANILA
EUSEBIO.CHELSEA@GMAIL.COM
#137 INT. F. BLUMENTRITT ST., BARANGAY TIBAGAN, SAN JUAN CITY, SAN JUAN MANILA
7253009
09156380311
STUDENT
NESTOR CUMPIO EUSEBIO FILIPINO
ALMA JAVIER PENERA FILIPINO
X
UU0046153
Manila 10/14/2006
X
X X
X
"To our valued clients:
To ensure quality service, this transaction may be recorded. Thank you for your understanding and support.
(Sa aming mga iginagalang na aplikante:
Para matiyak ang maayos na kalidad ng aming serbisyo, ang transakyong ito ay maaring i-rekord.
Maraming salamat sa inyong pang-unawa at suporta.)"
Sun, Jun 29, 2014 11:25 am f09226143860def32dc85d1124ab89bd776acf89
!"#$%!"&"'() +,! +%!)( (%&" -.))-,!( .--/%0.'()
-1234567 6881626591 045:;2<1= 6884;5><15> '4 511= >4 3?@<;> 6 8633842> 3;A1 8B4>4
C?7D 6994<87;3B1= 6887;96>;45 :42< - !"# %& '()*+("'&' ,-(! ./& 012 )&%34.&5 !!!"#$%"&'(")*
E;2>B 012>;:;96>1 (BC) in Secuiity Papei (SECPA) issueu by the '6>;4567 )>6>;3>;93 ,::;91 (NS0) oi Ceitifieu Tiue Copy (CTC) of
BC issueu by the Local Civil Registiai (LCR) & uuly authenticateu by NS0. Tiansciibeu BC fiom the LCR is iequiieu when entiies
in NS0 BC aie bluiieu oi unieauable. Repoit of Biith uuly authenticateu by NS0 is iequiieu if boin abioau.
F67;= 8;9>?21 %C3 65= 3?8842>;5G =49?<15>3 >4 824H1 ;=15>;>D (please iefei to the List of Acceptable IBs & Suppoiting
Bocuments below)
%5 0631 4: '4 E;2>B !1942=I
%: @425 ;5 42 6:>12 JKLM NO65?62D JP JKLM 42 6:>12QI
Apply foi the uelayeu iegistiation of biith at the local civil iegistiy office locateu at the place of biith of applicant
Submit authenticateu Biith Ceitificate fiom NS0 anu suppoiting public uocuments upon the uiscietion of the piocessoi oi
Consulai 0fficei, with coiiect uate anu place of biith {i.e. Iorm 1S7, voters Reqistrotion RecorJ, Boptismol Certificote witb -&"'"%+&
'-# 3&"+ (- 6781 9 :82 7&-.4,4;".& )4./ </(.( "*' -&"'"%+& '-# 3&"+5 ,(- 8=3+4! "<<+4;"*.3>
%: @425 @1:421 JKLM 65= @174R NC191<@12 SJP JKTK 65= @174RQI
Ceitificate of Non-availability of Biith Recoiu fiom NS0
Notaiizeu }oint Biith Affiuavit of Two Bisinteiesteu Peisons
Any public uocument with coiiect full name, uate anu place of biith ?4@&@ A"<.43!"+ 7&-.4,4;".& )4./ -&"'"%+& '-# 3&"+ (- 6781 9
:82 7&-.4,4;".& )4./ </(.( "*' -&"'"%+& '-# 3&"+5 ,(- 8=3+4! "<<+4;"*.3>
.==;>;4567 !1U?;21<15>3
+42 <622;1= R4<15I
Naiiiage Contiact (NC) in Secuiity Papei issueu by NS0 oi oiiginal anu photocopy of the Ceitifieu Tiue Copy of NC issueu by
the Local Civil Registiai anu uuly authenticateu by NS0. Tiansciibeu NC fiom the LCR is iequiieu when entiies in NS0 NC aie
bluiieu oi unieauable. Repoit of Naiiiage uuly authenticateu by NS0 is iequiieu if maiiieu abioau.
+42 384?31 4: :421;G5 56>;4567I
Naiiiage Contiact (NC) in Secuiity Papei issueu by NS0 oi Ceitifieu Tiue Copy of NC issueu by the Local Civil Registiai anu
uuly authenticateu by NS0. Tiansciibeu NC fiom the LCR is iequiieu when entiies in NS0 NC aie bluiieu oi unieauable.
Repoit of Naiiiage uuly authenticateu by NS0 is iequiieu if maiiieu abioau.
0iiginal anu photocopy of Commission of Filipinos 0veiseas (CF0) uuiuance anu Counseling Ceitificate of Attenuance
?-&B=4-&' ,(- ,4-3. .4!& "<<+4;"*.3 (- -&*&)"+ (, <"33<(-. .( %& =3&' ,(- ./& ,4-3. .4!& ./& 3=-*"!& (, ./& /=3%"*'>
.7;153 RB4 69U?;21= +;7;8;54 9;>;A153B;8 42 6887;965>3 R;>B $'+,-&./0'1.#-.& $%3-45 .%3,0 N1VGV /%&P 0W,P )XP /""P
).&.C%P )%'YWP 1>9VQI
Buieau of Immigiation Iuentification Ceitificate
Ceitificate of Natuialization
Election of Filipino Citizenship 0ath of Allegiance
IF NECESSARY,
Naiiiage Ceitificate of paients (uuly authenticateu by NS0)
NS0 Biith Ceitificate of applicant's biothei oi sistei
.887;965>3 RB4 6H6;71= 4: 61%4 7-8-9,.0*-) 42 :4,;8-'. '$ <*-4-))-., 7-8-9,.0*-) ?5=12 !. KZZLI
Iuentification Ceitificate
0ath of Allegiance
0iuei of Appioval
Repoit of Biith (foi those boin abioau)
%: 6887;965> ;3 6 C,)( 39B4762I (same geneial iequiiements stateu above)
Secuie a ceitification oi cleaiance fiom B0ST
+42 &;542 .887;965>3 N@174R J[ D1623 47==
Confiimeu appointment (except foi 1 yeai olu anu below)
Peisonal appeaiance of the minoi applicant
Peisonal appeaiance of eithei paient, NS0 Naiiiage Contiact anu piopei IB valiu passpoit of paients (if minoi is a legitimate
chilu) Peisonal appeaiance of mothei anu piopei IB valiu passpoit of mothei (if minoi is an illegitimate chilu)
0iiginal anu photocopy of valiu passpoit of the peison tiaveling with the minoi
Notaiizeu Affiuavit of Suppoit anu Consent to tiavel fiom eithei paient (if minoi is a legitimate chilu) fiom mothei (if minoi is
an illegitimate chilu)
0iiginal E;2>B 012>;:;96>1 (BC) of minoi in Secuiity Papei issueu by NS0 oi Ceitifieu Tiue Copy of BC issueu by the LCR &
uuly authenticateu by NS0. Tiansciibeu BC fiom the LCR is iequiieu when entiies in NS0 BC aie bluiieu oi unieauable.
Repoit of Biith uuly authenticateu by NS0 is iequiieu if minoi was boin abioau.
Bocument of iuentity with photo, if minoi is 8-17 yeais olu (foi fiist time & ienewal applicant) such as School I.B. oi Foim
1S7 with ieauable uiy seal. Foi minoi applicants who nevei attenueu school, a Notaiizeu Affiuavit of Explanation executeu by
eithei paient (if minoi is a legitimate chilu) by mothei (if minoi is an illegitimate chilu) uetailing the ieasons why the chilu
is not in school, is iequiieu
.==;>;4567 !1U?;21<15>3
%: <;542 ;3 54> >26H17;5G R;>B 1;>B12 86215> 42 67451I
Peisonal appeaiance of the mothei is iequiieu if minoi applicant is an illegitimate chilu.
Affiuavit of Suppoit anu Consent (ASC) executeu by eithei paient inuicating the name of the tiaveling companion anu
ielationship to the minoi. If minoi will be tiaveling alone, ASC must be executeu by eithei paient, stating that hishei chilu will be
tiaveling alone. If minoi is illegitimate, mothei shoulu execute the ASC.
0iiginal anu photocopy of BSWB Cleaiance. Theie is no neeu to secuie a BSWB Cleaiance if the minoi tiaveling abioau has
paients who aie in the Foieign Seivice oi living abioau oi aie immigiants, pioviueu he she is holuing a valiu pass such as a
uepenuent's visa pass iuentification caiu oi peimanent iesiuent visa pass iuentification caiu which seives as pioof that he
she is living with paients abioau.
%: @4>B 86215>3 621 6@246=I
Affiuavit of Suppoit anu Consent (ASC) executeu by eithei paient inuicating the name of the tiaveling companion (authenticateu
by the neaiest Philippine Embassy oi Consulate ueneial). If minoi is illegitimate, mothei shoulu execute the ASC.
Special Powei of Attoiney (SPA) with an attacheu photocopy of eithei paient's valiu passpoit (authenticateu by the neaiest
Philippine Embassy oi Consulate ueneial) authoiizing a iepiesentative in assisting the chilu to apply foi a passpoit. If minoi is
illegitimate, mothei shoulu execute the SPA.
0iiginal anu photocopy of BSWB Cleaiance. Theie is no neeu to secuie a BSWB Cleaiance if the minoi tiaveling abioau has
paients who aie in the Foieign Seivice oi living abioau oi aie immigiants, pioviueu he she is holuing a valiu pass such as a
uepenuent's visa pass iuentification caiu oi peimanent iesiuent visa pass iuentification caiu which seives as pioof that he
she is living with paients abioau.
Piopei IB of the uuly authoiizeu iepiesentative (Please iefei to List of Acceptable IBs)

%: <;542 ;3 71G;>;<6>1= @D 3?@31U?15> <622;6G1 4: 86215>3I
Authenticateu Biith Ceitificate fiom NS0 with annotation iegaiuing new status as legitimateu anu the full name of the chilu
%: <;542 ;3 ;771G;>;<6>1 @?> 69\54R71=G1= @D :6>B12I
Biith ceitificate fiom NS0 ieflecting suiname of fathei with Affiuavit of Acknowleugement anu Consent to use suiname of fathei
,28B651= <;542 6887;965>I
Authenticateu Beath Ceitificates of paients fiom NS0
Couit oiuei awaiuing guaiuianship of the oiphaneu minoi applicant oi substitute paiental authoiity unuei Aiticle 214 & 216 of
the Family Coue
BSWB Cleaiance
.@65=451= <;542 6887;965>I
Couit oiuei awaiuing guaiuianship of the abanuoneu minoi applicant oi substitute paiental authoiity
BSWB Tiavel Cleaiance
+4?5=7;5GI
Ceitificate of founuling authenticateu by NS0
BSWB Cleaiance
Passpoit of the peison who founu the applicant
Lettei of authoiity oi enuoisement fiom BSWB foi the issuance of passpoit
/1G677D 6=48>1=I
0iiginal anu Ceitifieu Tiue Copy (CTC) of NS0 Biith Ceitificate befoie auoption
0iiginal anu Ceitifieu Tiue Copy (CTC) of the NS0 amenueu Biith Ceitificate aftei auoption
Ceitifieu Tiue Copy (CTC) of the Couit Becision oi 0iuei on Auoption anu Ceitificate of Finality
BSWB cleaiance foi minoi applicant, if tiaveling with the peison othei than the auopting paients

C* ;"3& ./& "<<+4;"*. 43 ,(- "'(<.4(* %# ,(-&4D* <"-&*.3E
Ceitifieu Tiue Copy of the Couit Beciee of Abanuonment of Chilu
NS0 Beath Ceitificate of the chilu's paients oi the Beeu of voluntaiy Commitment executeu aftei the biith of the chilu
Enuoisement of chilu to the Inteicountiy Auoption Boaiu by the BSWB
Authenticateu Biith oi Founuling Ceitificate

&;542 6887;965> RB431 86215>3 621 655?771= ] =;H4291=I
Couit oiuei awaiuing guaiuianship of the minoi applicant oi substitute paiental authoiity
BSWB Tiavel Cleaiance
NS0 Naiiiage Ceitificate with annotation on nullity oi annulment ueciee

&;542 6887;965> RB431 <4>B12 ;3 7;\1R;31 6 <;542I
Peisonal appeaiance of mothei anu mateinal gianupaients
NS0 Biith Ceitificate of minoi applicant anu mothei
Affiuavit of Suppoit anu Consent executeu by the mateinal gianupaients inuicating the name of the tiaveling companion
BSWB Cleaiance if minoi will be tiaveling with the peison othei than the mateinal gianupaients
Pioof of iuentity of mothei anu mateinal gianupaients (Please iefei to List of Acceptable IBs)

+42 &?37;< 6887;965>3 (same geneial iequiiements stateu above)
+42 76>1 21G;3>121= &?37;< 6887;965>3I
Ceitificate of Tiibal Affiliation fiom the National Commission on Nuslim Filipinos (NCNF)
+42 945H12>3 RB4 R4?7= 7;\1 >4 ?31 >B1;2 &?37;< 56<1I
Annotateu Biith Ceitificate (BC) in Secuiity Papei (SECPA) issueu by NS0 beaiing the Nuslim name
NCNF 0NA Ceitificate of Conveision
!"#$%!"&"'() +,! !"'"^./ ,+ -.))-,!(
-1234567 6881626591 045:;2<1= .884;5><15> C?7D 6994<87;3B1= 6887;96>;45 :42< - !"# %& '()*+("'&' ,-(! ./& 012 )&%34.&5 !!!"#$%"&'(")* '4 511= >4 3?@<;> 6 8633842> 3;A1 8B4>4
&43> 21915> 1_8;2;5G 42 1_8;21= 8633842> F67;= 8;9>?21 %C3 65= 3?8842>;5G =49?<15>3 >4 824H1 ;=15>;>DV (Please iefei to List of Acceptable IBs anu List of Suppoiting Bocuments)
E24R5 -633842> 42 8633842>3 ;33?1= 82;42 >4 MJ &6D JKKLI
Biing oiiginal biown passpoit anu photocopy of passpoit pages 1,2,S,4 anu last page
E;2>B 012>;:;96>1 in Secuiity Papei issueu by NS0 oi Ceitifieu Tiue Copy of BC issueu by the Local Civil Registiai anu uuly
authenticateu by NS0, to ueteimine complete miuule name. Tiansciibeu Biith Ceitificate fiom the LCR is iequiieu when entiies in
NS0 Biith Ceitificate aie bluiieu oi unieauable. Repoit of Biith uuly authenticateu by NS0 if boin abioau
Y2115 -633842> 42 8633842>3 ;33?1= 6:>12 MJ &6D JKKLI
Biing oiiginal gieen passpoit anu photocopy of fiist anu last page of passpoit
&69B;51 !16=6@71 -633842> N&!-Q ;33?1= ;5 >B1 D162 ZMM`I
Biing oiiginal passpoit anu photocopy of fiist anu last page of passpoit
E;2>B 012>;:;96>1 (BC) in Secuiity Papei (SECPA) issueu by the '6>;4567 )>6>;3>;93 ,::;91 (NS0) oi Ceitifieu Tiue Copy
(CTC) of BC issueu by the Local Civil Registiai (LCR) to ueteimine complete place of biith. Tiansciibeu Biith Ceitificate fiom
the LCR is iequiieu when entiies in NS0 Biith Ceitificate aie bluiieu oi unieauable
0lu cancelleu passpoit may also be piesenteu in the absence of an NS0 Biith Ceitificate
"719>245;9 -633842> N"a8633842>Q
Biing oiiginal e-passpoit anu photocopy of fiist (uata page) anu last page of passpoit
+42 <622;1= R4<15 RB4 R4?7= 7;\1 >4 ?31 >B1;2 <622;1= 3?256<1I
Naiiiage Contiact (NC) in Secuiity Papei issueu by NS0 oi Ceitifieu Tiue Copy of NC issueu by the Local Civil Registiai anu
uuly authenticateu by NS0. Tiansciibeu Naiiiage Contiact fiom the LCR is iequiieu when entiies in NS0 Naiiiage Contiact aie
bluiieu oi unieauable. Repoit of Naiiiage uuly authenticateu by NS0 if maiiieu abioau
+42 384?31 4: :421;G5 56>;4567 RB4 R4?7= 7;\1 >4 ?31 >B1;2 <622;1= 3?256<1I
Naiiiage Contiact (NC) in Secuiity Papei issueu by NS0 oi Ceitifieu Tiue Copy of NC issueu by the Local Civil Registiai anu
uuly authenticateu by NS0. Tiansciibeu Naiiiage Contiact fiom the LCR is iequiieu when entiies in NS0 Naiiiage Contiact aie
bluiieu oi unieauable. Repoit of Naiiiage uuly authenticateu by NS0 if maiiieu abioau
0iiginal anu photocopy of Commission of Filipino 0veiseas (CF0) uuiuance anu Counseling Ceitificate of Attenuance ?-&B=4-&'
,(- ,4-3. .4!& "<<+4;"*.3 (- -&*&)"+ (, <"33<(-. .( %& =3&' ,(- ./& ,4-3. .4!& ./& 3=-*"!& (, ./& /=3%"*'>
+42 <622;1= R4<15 RB4 R4?7= 7;\1 >4 21H12> >4 >B1;2 <6;=15 56<1I
E;2>B 012>;:;96>1 (BC) in Secuiity Papei (SECPA) issueu by NS0 oi Ceitifieu Tiue Copy of BC issueu by the Local Civil Registiai
anu uuly authenticateu by NS0. Tiansciibeu Biith Ceitificate fiom the LCR is iequiieu when entiies in NS0 Biith Ceitificate aie
bluiieu oi unieauable. Repoit of Biith uuly authenticateu by NS0 is iequiieu if boin abioau
>$ %4+,%#5 !-#'!,#E Beath Ceitificate in Secuiity Papei (SECPA) issueu by NS0 of the ueceaseu husbanu
>$ 3%++-%&, -0 %..144,#E Ceitifieu Tiue Copy of annotateu NS0 Naiiiage Contiact anu Couit 0iuei effecting the annulment.
>$ #-('+;,#E Ceitifieu Tiue Copy of the Bivoice Beciee uuly authenticateu by the Philippine Embassy oi Consulate wheie the
uivoice was obtaineu oi by the conceineu foieign uiplomatic oi consulai mission in the Philippines. 0iiginal anu CTC of Phil.
Couit iecognition of foieign uivoice ueciee must also be piesent anu the NS0 NC with the annotation of the Bivoice Beciee.
+42 <;542 6887;965>3, iequiiements foi fiist time minoi applicants aie still piesciibeu, in auuition to the passpoit of
minoi.
+42 &?37;< .887;965>3 (same geneial iequiiements stateu above)
+42 945H12>3 RB4 R4?7= 7;\1 >4 ?31 >B1;2 &?37;< 56<1I
Annotateu Biith Ceitificate (BC) in Secuiity Papei (SECPA) issueu by NS0 beaiing the Nuslim name
National Commission on Nuslim Filipinos (NCNF) oi 0ffice on Nuslim Affaiis (0NA) Ceitificate of Conveision
.7;153 RB4 69U?;21= +;7;8;54 9;>;A153B;8 42 6887;965>3 R;>B $'+,-&./0'1.#-.& $%3-45 .%3,0 N1VGV /%&P 0W,P )XP /""P
).&.C%P )%'YWP 1>9VQI
Buieau of Immigiation Iuentification Ceitificate IF NECESSARY,
Ceitificate of Natuialization NS0 Naiiiage Ceitificate of paients
Election of Filipino Citizenship 0ath of Allegiance NS0 Biith Ceitificate of applicant oi applicant's biothei sistei
.887;965>3 RB4 6H6;71= 4: 61%4 7-8-9,.0*-) 42 :4,;8-'. '$ <*-4-))-., 7-8-9,.0*-) ?5=12 !. KZZLI
Iuentification Ceitificate
0ath of Allegiance
0iuei of Appioval
Repoit of Biith (foi those boin abioau)
%: 6887;965> ;3 6 C,)( )9B4762 (same geneial iequiiements stateu above):
Secuie a ceitification oi cleaiance fiom B0ST
!"#$%!"&"'() +,! !"-/.0"&"'( ,+ /,)( -.))-,!()
-1234567 6881626591 045:;2<1= .884;5><15> '4 511= >4 3?@<;> 6 8633842> 3;A1 8B4>4
C?7D 6994<87;3B1= 6887;96>;45 :42< - !"# %& '()*+("'&' ,-(! ./& 012 )&%34.&5 !!!"#$%"&'(")*
/%)( ,+ .00"-(.E/" %C) N.> 7163> J 4: >B1 :4774R;5GQI
Y4H125<15>a;33?1= %C3 such as uigitizeu SSS IB, Biivei's License, uSIS E-caiu, PRC IB, IBP IB, 0WWA IB, uigitizeu BIR IB,
Senioi Citizen's IB. ,>B12 69918>6@71 8;9>?21 %C3 incluue olu College IB, Alumni IB, oi olu Employment IBs

/%)( ,+ )$--,!(%'Y C,0$&"'() N.> 7163> S 4: >B1 :4774R;5GQI
votei's IB
NS0 Naiiiage Contiact
Lanu Title
Seaman's Book
Elementaiy oi Bigh School Foim 1S7 oi Tiansciipt of Recoius with ieauable uiy seal
uoveinment Seivice Recoiu
NBI Cleaiance
Police Cleaiance
Baiangay Cleaiance
0lu uocuments issueu at least one yeai piioi to uate of application that show coiiect name, uate anu place of biith, pictuie
anu signatuie of applicant such as: NS0 Biith Ceitificate of chiluchiluien, SSS-E1 Foim oi Niciofilmeu copy of SSS-E1 Foim,
Income Tax Retuin, votei's Ceitification, List of voteis anu votei's Registiation Recoiu (foi newly issueu vRR, please attach
ieceipt), School Yeaibook, oi Community Tax Ceitificate
%5 9631 8633842> R63 743> 65= 96554> @1 :4?5=I
Submit '4>62;A1= .::;=6H;> 4: /433 (with uetaileu explanation on when, wheie anu how passpoit got lost).
If the lost passpoit is still valiu, submit -47;91 !1842>V
Photocopy of fiist page of lost passpoit (if available)
F/&-& )4++ %& " ?@/#%5 ;4,%+-.& ),+-'# <-4(- .( ./& <-(;&334*D (, "<<+4;".4(* ,(- -&<+";&!&*. (, " +(3. G"+4' <"33<(-.@
%5 9631 8633842> R63 67216=D =197621= 743> @D >B1 6887;965> @?> 1H15>?677D R63 :4?5= 65= 21>?251= >4 B;<]B12I
'4>62;A1= .::;=6H;> 4: !1>2;1H67 (with uetaileu explanation on when, wheie anu how passpoit was founu)
0iiginal anu photocopy of fiist anu last page of passpoit

%5 9631 4: <?>;76>1= 42 =6<6G1= 8633842>3I
'4>62;A1= .::;=6H;> 4: &?>;76>;45 (with uetaileu explanation on when, wheie anu how passpoit got mutilateu oi uamageu)
0iiginal anu photocopy of fiist anu last page of mutilateu oi uamageu passpoit
%5 9631 6887;965> R63 ;33?1= 6 (26H17 C49?<15>I
0iiginal Tiavel Bocument
'4>62;A1= .::;=6H;> 4: "_87656>;45 !1G62=;5G %33?6591 4: (26H17 C49?<15> (with uetaileu explanation on when, wheie anu
why applicant was issueu a tiavel uocument)
0iiginal anu photocopy of fiist anu last page of cancelleu passpoit (if passpoit is still in the possession of the applicant)
!"&%'C"!)
Peisonal appeaiance is iequiieu foi all applicants
Confiimeu appointment is iequiieu foi all applicants except senioi citizens, infants & minois below 1 yeai olu anu 0FWs. Foi
0FWs, sufficient pioof must be submitteu such as valiu employment contiact oi 0EC.
Eaiiings & contact lenses aie not alloweu uuiing uata captuiing. Smiling with visible teeth is also not alloweu.
Check all uata in the computei monitoi & in the Eniolment Ceitificate befoie signing.
0nly immeuiate family membeis aie alloweu to get the passpoit in behalf of the applicant. Immeuiate family membeis incluue
fathei, mothei, biothei, sistei, spouse anu chiluien of legal age.
Passpoit shall be ieleaseu to an immeuiate family membei only with piopei authoiization lettei. Passpoit of a minoi
applicant shall be ieleaseu to paients only oi to an authoiizeu iepiesentative with Special Powei of Attoiney & Affiuavit
of Suppoit anu Consent.
Passpoits unclaimeu aftei 6 months will be cancelleu pei Bepaitment 0iuei No. S7-uS.
Check all uata in the ieceiveu e-passpoit upon ielease.
Numbei of piocessing uays may vaiy uepenuing on the location of the Regional Consulai 0ffice wheie the application was
fileu.
The Bepaitment may iequiie auuitional suppoiting uocuments as may be necessaiy, especially foi applicants with uual
citizenship anu with foieign-sounuing family names to piove citizenship.
-.))-,!( +"")I
!1G?762 -249133;5G (1S woiking uays) : P9Su.uu
"_81=;>1= -249133;5G (7 woiking uays): P1,2uu.uu
+42 !187691<15> 4: 6 743> H67;= 8633842>: Auuitional fee of P2uu.uu foi a lost valiu NRRPNRP oi PSSu.uu foi a lost valiu e-
passpoit
.887D :42 D4?2 8633842> 1627DP 8218621 21U?;21<15>3 @1:421 6884;5><15> =6>1P 545a,+^ 65= &1>24 &65;76a@631=
6887;965>3 3B4?7= 319?21 65 6884;5><15> RB15 6887D;5G :42 6 8633842>P >B431 ;5 824H;5913 965 6887D 6> >B1 516213>
!1G;4567 0453?762 ,::;91 42 =?2;5G &4@;71 -633842> )12H;91 N&-)QP ,+^3 965 6887D 6> >B1 -633842> "_>153;45 ,::;91
7496>1= 6> >B1 -,". ;5 ,2>;G63P =4 54> =167 R;>B :;_123P 6H6;7 4: >B1 8633842> =17;H12D 312H;91 b >6\1 G44= 9621 4: D4?2
8633842>V +42 94<<15>3P 94<876;5>3 b 633;3>6591P 871631 945>69> >B1 -?@7;9 .33;3>6591 015>12 42 >B1 -633842>
Director's Uffice.

"#$%&"#'#()* +"# ,+*#- ."/' "0+01234 /" )5# 65&7&66&(# 6+**6/") +8) /. 944: +(- &)* &'67#'#()&(; "%7#* +(- "#;%7+)&/(*0

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