Revised DPRM Form 1B-2007

PHILIPPINE NATIONAL POLICE

ID APPLICATION FORM
(PNP Dependents)
Fill in all applicable spaces. Mark all appropriate boxes with x

CATEGORY:

Status of PNP Personnel:

Active
Retired
Deceased

Form Control No.

Purpose of Application:
New
Renewal/Update
REQUIREMENTS:

DEPENDENT DATA
APPLICANTS
NAME:

BIRTHDATE

_________________ ________________ ______________ _______

Last
First
Middle
Qualifier

(MM/DD/YY):
HOME ADDRESS:
RELATIONSHIP:
WEIGHT:
COLOR OF EYES:
BLOOD TYPE:
TIN:

HEIGHT:
COLOR OF HAIR:
RELIGION:
OTHER IDENTIFYING
DATA:
PERSON O BE NOTIFIED IN CASE OF EMERGENCY:

(in Kg)

(in Cm)

POLICE PERSONNEL DATA

________________ ________________ ______________ _______
Last
First
Middle
Qualifier

RANK/DESIGNATION:

BADGE NUMBER:

PRESENT UNIT (If Retired, Last Unit):

ADDRESS:
Date _____________
I declare, under the penalties of perjury, that this ID Application form has been
accomplished in good faith, verified by me, and to the best of my knowledge and
belief, is true and correct, pursuant to the provisions of pertinent laws, rules and
regulations of the Republic of the Philippines.
I also authorize the PNP/authorized representative to verify/validate the contents
stated herein. (Please affix your signature at the box below)

1. APPLICATION FOPRM ENDORSED BY

ADMIN/PERS OFFICER
2. CERTIFICATE OF LEGAL BENEFICIARIES
(CLB) FROM RMD.
Without CLB from RMD, please
Submit the following:
a. Affidavit of Confirmation;
b. Certificate of Legal
Beneficiaries from Unit;
c .NSO copy of Birth Certificate
(Children); and
d. NSO copy of Marriage
Certificate (husband/wife of
PNP personnel)
3. PHOTOCOPY OF PNP ID OF THE SPONSOR.
4. AFFIDAVIT OF LOSS, If loss.
5. NSO copy of DEATH CERTIFICATE, if
deceased PNP member.
6. PAYMENT OF 60.00 PESOS FOR THE
DEPENDENT ID CARD.

PROCEDURES IN THE APPLICATION

AND PROCESSING OF ID CARDs:

TEL. NO. OF PERSON TO BE NOTIFIED:

DEPENDENT OF:
(Name of PNP
Personnel)

Replacement

1. SUBMIT ACCOMPLISHED APPLICATION

FORM & REQUIRED DOCUMENTS TO THE
CHIEF, RPHRDD/ADMIN/PERSONNEL OFFICER
FOR THE PREPARATION OF ENDORSEMENT.
2. THE APPLICATION TOGETHER WITH ITS
CORRESPONDING ENDORSEMENT
WILL BE FORWARDED TO THE RECORDS
MANAGEMENT DIVISION (RMD), DPRM THRU
THEIR LIAISON OFFICER.
3. THE MESSAGE CENTER, RMD WILL LOG
AND VERIFY THE APPLICATION. IF
COMPLETE/CORRECT, IT WILL BE
FORWARDED TO THE ID SECTION.
4. THE ID SECTION WILL VALIDATE AND
FORWARD THE APPLICATION TO THE OFFICE
OF THE EXECUTIVE OFFICER, DPRM FOR
APPROVAL & SIGNATURE OF THE ID CARD.
5. THE APPROVED APPLICATION WILL BE
RETURNED TO THE ID SECTION.
6. THE ID CARD WILL BE RETURNED TO THE
MESSAGE CENTER, RMD FOR
CONSOLIDATION AND CONSEQUENTLY
WILL BE RELEASED TO THE CONCERNED
LIAISON OFFICERS.
7. THE LIAISON OFFICERS WILL RETURN
THE ID CARD TO THE CHIEF,
RPHRDD/ADMIN/PERSONNEL OFFICER FOR
DISTRIBUTION TO THE CONCERNED

PERSONNEL

2x2 COLORED PICTURE

WITH
WHITE BACKGROUND
Signature of Applicant (in black pen)
RECOMMENDED BY:
(Signature over Printed Name)

CHIEF, RPHRDD/ADMIN/PERS OFFICER

RANK

UNIT

Right Thumb Mark

PROCESSED BY:

APPROVED BY:

ACTION CLERK, ID SECTION, RMD, DPRM

FOR TDPRM:

REVIEWED BY:

MANUEL RABAGO GAERLAN, CEO VI

Police Senior Superintendent (DSC)
Chief, Records Management Division