Foreign Service Of The Philippines
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1
2Foreign Service of the Philippines
PHILIPPINE CONSULATE GENERAL
Toronto, Ontario, Canada
PASSPORT APPLICATION FORM
FILL- IN BLANKS. TYPE OR PRINT LEGIBLY. (Please see requirements on the reverse side)
SURNAME____________________________________________________
GIVEN NAME_________________________________________________
MIDDLE/MAIDEN NAME________________________________________
DATE OF BIRTH
___________
________(DAY)____
____
______ (MONTH)_
___________________(YEAR)________
PLACE OF BIRTH
________________________(TOWN / CITY)
_____________(PROVINCE)______ ____________
SEX
/ / Male
/ / Female
CIVIL STATUS:
/ / Single
/ /Married
/ /Widow/er
/ / Annulled
/ /Divorced
Name of Father:___________________________________
Father’s Citizenship:______________________
Name of Mother:___________________________________
Mothers’ Citizenship:______________________
Name of Spouse, if married __________________________
Spouse’s Citizenship:_____________________
If widowed or divorced, name of previous spouse:_________________________________________________
ADDRESS IN CANADA:
_________________________________________________________________________________________
Number
Street
Town/City
Province
Postal Code
Telephone No.
ADDRESS IN PHILIPPINES/Name of person to be notified in case of emergency:
Name:____________________________________________________________________________________
_________________________________________________________________________________________
Number
Street
Town/City
Province
Telephone No.
LEGAL STATUS IN CANADA:
/ /Permanent Resident / /Contract Worker / /Seaman / /Student / /Tourist / /Others______________
OCCUPATION:__________________________________________
Name of Employer:_______________________________________
Address:________________________________________________ Telephone No. ____________________
HAVE YOU APPLIED FOR FOREIGN CITIZENSHIP: YES ______
NO ______
IF YES, PLEASE SPECIFY : _________________________________ STATUS : _______________________
CHECK IF YOU ARE:
HAVE YOU EVER BEEN ISSUED A PHILIPPINE PASSPORT?
/ / Legitimate / / Illegitimate
/ / Yes
/ / No
Latest Passport No. ___________________________
PHILIPPINE CITIZENSHIP ACQUIRED BY:
Date of Issue _______________________________
/ / Birth
/ / Election
Place of Issue ________________________________
/ / Naturalization / / Marriage
DO YOU HAVE VALID VISA/S IN YOUR PASSPORT? / / Yes
/ / No
WHICH PAGE / S : ____________________________________
I SOLEMNLY SWEAR that the photographs submitted is mine, that the statements made on this
Application Form are true and the attached supporting documents are authentic.* SO HELP ME GOD.
*Perjury is punishable by law.
Left Thumb Mark
Right Thumb Mark
______________________________________________
Signature of Applicant
Date:________________________________
IMPORTANT : IF THE APPLICANT IS UNABLE TO APPLY IN PERSON, THIS FORM MUST BE NOTARIZED
SUBSCRIBE AND SWORN to before me this _________ day of ________________________________
at _______________________________________________________________________________________________
_________________________________
Notary Public
FOR OFFICIAL USE ONLY
New Passport No._______________________ Date of Issue________________ Service No.____________
DOCUMENT/S SEEN AND RETURNED TO APPLICANT:
PR CARD
RECORD OF LANDING
WORKING PERMIT
VISITOR’S RECORD
OTHERS____________
Processor : _________________________________
Signing Officer : __________________________
Old and new passports are received by:____________________Date _____________
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