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NOT FOR SALE

Republic of the Philippines


PRC-BRO Reg. Form No. 3 (Rev. 12/3/15)
Professional Regulation Commission
RENEWAL
Baguio City
DUPLICATE
CHANGE OF NAME/STATUS
REGULATION DIVISION
REPRINT
APPLICATION FOR PROFESSIONAL IDENTIFICATION CARD (PIC)

REPRODUCTION IS ALLOWED

NAME: _

_,

Last Name

First Name

PERMANENT ADDRESS:
DATE FILED: _

Middle Name

PROFESSION: _

ZIP CODE:
EXAM DATE: _

(mm/dd/yy)

(mm/dd/yy)

EXPIRATION DATE: _

REGISTRATION NO:

REGISTRATION DATE:
(mm/dd/yy)

CITIZENSHIP:

(VALID UNTIL)

BIRTH DATE:

(mm/dd/yy)

E-MAIL/CELL NO./TEL NO.

(mm/dd/yy)

This is to certify that all the information above are true and correct.
SIGNATURE OF LICENSEE
FOR PRC PROCESSING

YLP FROM:

TO:
SURCHARGE:
TOTAL AMOUNT:

VERIFIED AND ASSESSED BY:

Amount:
Date:

_____________

ID CLAIM SLIP

PLEASE FILL THIS PORTION


NAME:
PROFESSION:
REGISTRATION NO.:
APPLICATION TYPE:

OR No:
Issued by:

ORIGINAL ID

ISSUED BY:

Date

AMOUNT PAID:
OFFICIAL RECEIPT NO.:
DATE PAID:
DUPLICATE
REPRINT

CHANGE OF NAME

To check if your PIC is ready for release, visit www.prcbaguio.blogspot.com for PIC availability (PICAV) or call/text 09277880145 or email us at
prcbaguio.releasing@gmail.com. To claim your PIC, present this slip at Counter 14. Representative shall present this claim slip, valid ID of the representative and
authorization letter from the Professional. For schedule of mobile processing visit our website (www.prcbaguio.blogspot.com).

NOT FOR SALE

PRC-BRO Reg. Form No. 3 (Rev. 12/3/15)

Republic of the Philippines


Professional
Regulation Commission
RENEWAL
DUPLICATE
Baguio City
CHANGE OF NAME/STATUS
REPRINT
REGULATION DIVISION
APPLICATION FOR PROFESSIONAL IDENTIFICATION CARD (PIC)

REPRODUCTION IS ALLOWED

NAME: _

_,

_ _

Last Name

First Name

DATE FILED: _

Middle Name

PERMANENT ADDRESS:

_
_

ZIP CODE:

PROFESSION: _

EXAM DATE: _

(mm/dd/yy)

(mm/dd/yy)

EXPIRATION DATE: _

REGISTRATION NO:

REGISTRATION DATE:
(mm/dd/yy)

CITIZENSHIP:

(VALID UNTIL)

BIRTH DATE:

E-MAIL/CELL NO./TEL NO.

(mm/dd/yy)

(mm/dd/yy)

This is to certify that all the information above are true and correct.
SIGNATURE OF LICENSEE
FOR PRC PROCESSING

YLP FROM:

TO:

SURCHARGE:
TOTAL AMOUNT:

VERIFIED AND ASSESSED BY:

Amount:
Date:

OR No:
Issued by:

_____________
ID CLAIM SLIP
ISSUED BY:

PLEASE FILL THIS PORTION


NAME:
PROFESSION:
REGISTRATION NO.:
APPLICATION TYPE:

ORIGINAL ID

AMOUNT PAID:
OFFICIAL RECEIPT NO.:
DATE PAID:
DUPLICATE
REPRINT

Date

CHANGE OF NAME

To check if your PIC is ready for release, visit www.prcbaguio.blogspot.com for PIC availability (PICAV) or call/text 09277880145 or email us at
prcbaguio.releasing@gmail.com. To claim your PIC, present this slip at Counter 14. Representative shall present this claim slip, valid ID of the representative and
authorization letter from the Professional. For schedule of mobile processing visit our website (www.prcbaguio.blogspot.com).

CITIZENS CHARTER REQUIREMENTS


1.
2.
3.
4.
5.
6.
7.
8.

Duly accomplished Form.


One (1) copy RECENT passport-size colored picture in white background with complete nametag (Last Name, First Name and Middle Name).
One photocopy of latest Professional Identification Card
In case of loss of unexpired Professional Identification Card, submit duly notarized Affidavit of Loss.
Marriage certificate from PSA/NSO (in security paper) for married female applicants who wish to apply for change of name due to marriage.
For Petition for correction of name and/or date of birth applicant submits copy of birth certificate from PSA/NSO in security paper (and PSA/NSO marriage
certificate for female married applicant) and duly notarized affidavit of explanation regarding request of correction;
Certificate of membership or official receipt issued by accredited professional organization as prescribed by respective boards(please refer below);
If the professional is abroad, he/she may renew his/her Professional Identification Card through representative.
ADDITIONAL REQUIREMENT/S AS PRESCRIBED BY RESPECTIVE BOARDS

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.

m.

AERONAUTICAL ENGINEER CERTIFICATE OF GOOD STANDING FROM SOCIETY OF AEROSPACE ENGINEERS OF THE PHILS. INC. (SAEP).
ARCHITECTS - CERTIFICATE OF GOOD STANDING/OFFICIAL RECEIPT ISSUED BY THE UAP
CUSTOMS BROKER CERTIFICATE OF GOOD STANDING ISSUED BY THE CCBI
ELECTRONICS ENGR/PROF. ELECTRONICS ENGR./ELECTRONICS TECHNICIAN - CERTIFICATE OF GOOD STANDING FROM IECEP.
GEODETIC ENGINEER. - CERTIFICATE OF GOOD STANDING ISSUED BY THE GEP
GUIDANCE COUNSELOR CERTIFICATE OF GOOD STANDING ISSUED BY THE PGCA
INTERIOR DESIGNER CERTIFICATE OF GOOD STANDING ISSUED BY PHILIPPINE INSTITUTE OF INTERIOR DESIGN (PIID).
LANDSCAPE ARCHITECT CERTIFICATE OF GOOD STANDING ISSUED BY PHILIPPINE ASSO. OF LANDSCAPE ARCHITECTS (PALA).
PROF. AGRI. ENGRS. CERTIFICATE OF GOOD STANDING ISSUED BY PSAE
PSYCHOLOGIST/PSYCHOMETRICIAN CERTIFICATE OF GOOD STANDING ISSUED BY THE PSYCHOLOGICAL ASSOCIATION OF THE PHILIPPINES (PAP).
REGISTERED ELECTRICAL ENGRS./RME/PEE - CERTIFICATE OF GOOD STANDING ISSUED BY THE IIEE/ IIEE LIFETIME MEMBERSHIP CARD.
REAL ESTATE PRACTITIONERS Notarized Certificate of Attendance to an Accredited (45 CPE Units) Program Administered by an Accredited Provider; For Salesperson, 10
CPE Units and photocopy of Real Estate Brokers PIC
For Private Practitioners: Indemnity Insurance/Cash or Surety Bond of Twenty Thousand Pesos (P20,000.00).
For Permanent Government Employee with Position/Item related to Profession: CERTIFICATE OF EMPLOYMENT.
RESPIRATORY THERAPIST CERTIFICATE OF GOOD STANDING ISSUED BY THE ASSOCIATION OF RESPIRATORY CARE PRACTITIONERS,
PHILIPPINES (ARCPP).

CITIZENS CHARTER PROCEDURES


Step 1 - Secure Renewal Form from the Public Assistance and Complaint Desk (PACD); or download renewal form at www.prcbaguio.blogspot.com.
Step 2 - Accomplish priority slip form and paste the picture; if no picture proceed to Customer Service Center, then to Counter 9 for assessment of fees and
evaluation of requirements;
Step 3 - Pay the assessed fee.
Step 4 - Receive Claim Slip from the Renewal Officer
NOTE: For change of registered name due to marriage and/or correction of entries, proceed to Counter 9 and submit renewal/petition form, photocopy of
Professional Identification Card, 1 passport size picture, and original PSA(formerly NSO) marriage certificate (for married female applicants only). Receive your ID
Claim and Acknowledgement Slip from the Renewal Officer.
As authorized representative, I hereby assume direct and full responsibility/liability for the professional ID card released to me.
________________________________________________________________
Signature over Printed Name of REPRESENTATIVE

CITIZENS CHARTER REQUIREMENTS


1.
2.
3.
4.
5.
6.
7.
8.

Duly accomplished Form.


One (1) copy RECENT passport-size colored picture in white background with complete nametag (Last Name, First Name and Middle Name).
One photocopy of latest Professional Identification Card.
In case of loss of unexpired Professional Identification Card, submit duly notarized Affidavit of Loss.
Marriage certificate from PSA/NSO (in security paper) for married female applicants who wish to apply for change of name due to marriage.
For Petition for correction of name and/or date of birth applicant submits copy of birth certificate from PSA/NSO in security paper (and PSA/NSO marriage
certificate for female married applicant) and duly notarized affidavit of explanation regarding request of correction;
Certificate of membership or official receipt issued by accredited professional organization as prescribed by respective boards(please refer below);
If the professional is abroad, he/she may renew his/her Professional Identification Card through representative.
ADDITIONAL REQUIREMENT/S AS PRESCRIBED BY RESPECTIVE BOARDS

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.

m.

AERONAUTICAL ENGINEER CERTIFICATE OF GOOD STANDING FROM SOCIETY OF AEROSPACE ENGINEERS OF THE PHILS. INC. (SAEP)
ARCHITECTS - CERTIFICATE OF GOOD STANDING/OFFICIAL RECEIPT ISSUED BY THE UAP
CUSTOMS BROKER CERTIFICATE OF GOOD STANDING ISSUED BY THE CCBI
ELECTRONICS ENGR/PROF. ELECTRONICS ENGR./ELECTRONICS TECHNICIAN - CERTIFICATE OF GOOD STANDING FROM IECEP.
GEODETIC ENGINEER. - CERTIFICATE OF GOOD STANDING ISSUED BY THE GEP
GUIDANCE COUNSELOR CERTIFICATE OF GOOD STANDING ISSUED BY THE PGCA
INTERIOR DESIGNER CERTIFICATE OF GOOD STANDING ISSUED BY PHILIPPINE INSTITUTE OF INTERIOR DESIGN (PIID).
LANDSCAPE ARCHITECT CERTIFICATE OF GOOD STANDING ISSUED BY PHILIPPINE ASSO. OF LANDSCAPE ARCHITECTS (PALA).
PROF. AGRI. ENGRS. CERTIFICATE OF GOOD STANDING ISSUED BY THE PSAE
PSYCHOLOGIST/PSYCHOMETRICIAN CERTIFICATE OF GOOD STANDING ISSUED BY THE PSYCHOLOGICAL ASSOCIATION OF THE PHILIPPINES (PAP).
REGISTERED ELECTRICAL ENGRS./RME/PEE - CERTIFICATE OF GOOD STANDING ISSUED BY THE IIEE/ IIEE LIFETIME MEMBERSHIP CARD
REAL ESTATE PRACTITIONERS Notarized Certificate of Attendance to an Accredited (45 CPE Units) Program Administered by an Accredited Provider; For Salesperson, 10
CPE Units and photocopy of Real Estate Brokers PIC
For Private Practitioners: Indemnity Insurance/Cash or Surety Bond of Twenty Thousand Pesos (P20,000.00).
For Permanent Government Employee with Position/Item related to Profession: CERTIFICATE OF EMPLOYMENT
RESPIRATORY THERAPIST CERTIFICATE OF GOOD STANDING ISSUED BY THE ASSOCIATION OF RESPIRATORY CARE PRACTITIONERS,
PHILIPPINES (ARCPP).

CITIZENS CHARTER PROCEDURES


Step 1 - Secure Renewal Form from the Public Assistance and Complaint Desk (PACD); or download renewal form at www.prcbaguio.blogspot.com.
Step 2 - Accomplish priority slip form and paste the picture; if no picture, proceed to Customer Service Center, then to Counter 9 for assessment of fees and
evaluation of requirements
Step 3 - Pay the assessed fee.
Step 4 - Receive Claim Slip from the Renewal Officer
NOTE: For change of registered name due to marriage and/or correction of entries, proceed to Counter 9 and submit renewal/petition form, photocopy of
Professional Identification Card, and 1 passport size picture, and original PSA(formerly NSO) marriage certificate (for married female applicants only). Receive
your Claim and Acknowledgement Slips from the Renewal Officer.
As the authorized representative, I hereby assume direct and full responsibility/liability for the professional ID card released to me.
________________________________________________________________
Signature over Printed Name of REPRESENTATIVE

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