Form 2014-08-006 - Application Form For Alien Certificate Of Registration Identity Card (Acr I-Card)
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2BI FORM 2014-08-006 Rev 0
This document cannot be reproducedand is NOT FOR SALE
APPLICATION FORM FOR ALIEN CERTIFICATE OF
REGISTRATION IDENTITY CARD (ACR I-CARD)
CONTROL NO:
APPLICATION NO:
I. GENERAL DETAILS
DEROGATORY RECORD
ACR Number
Official Receipt Number
NO DERO
W/ DERO
Checked by: _____________________________
Date of Issuance
Certificate of Residence Number (CRN)
[DD-MMM-YYYY e.g. 01 JAN 1990]
Date
: _____________________________
IDENTITY VERIFIED
Place of Issuance
_______________________________________
Fingerprint Examiner
Date
II. APPLICANT’S INFORMATION
RECOMMENDING
Name Prefix (e.g. ATTY, FR, SR)
APPROVAL
DENIAL
Remarks: _______________________________
Last Name
_______________________________________
_______________________________________
First/Given Name
Registration Officer
Date
REVIEWED BY:
Middle Name
_______________________________________
Reviewing Officer
Date
APPROVED BY:
Name Suffix (e.g. JR, SR, I-III)
_______________________________________
COMM/ARD CHIEF
Date
Other Name(s)/Alias(es)
1
2
Visa/Travel Information
Travel Document Details
Visa Number
Passport Number
Date of Issuance
Date of Issuance
[DD-MMM-YYYY e.g. 01 JAN 1990]
[DD-MMM-YYYY e.g. 01 JAN 1990]
Name of Consulate
Expiry Date/Valid Until
[DD-MMM-YYYY e.g. 01 JAN 1990]
Admission Status of Latest Arrival
Place of Issuance
Length of Stay
Contact Number(s) in the Philippines
Landline
Present Status
Mobile
Email Address
Other Information
Residential Address in the Philippines
Previous ACR Number
House/Unit No., Street, Subdivision/Village
Date of Issuance
Barangay, City/Municipality
[DD-MMM-YYYY e.g. 01 JAN 1990]
Place of Issuance
Province, Zip Code
Citizenship/Nationality
Previous Subject of
Personal Description
Personal Information
Race
Blood Type
Gender
Male
Female
Height [cm]
Eye Color
Civil Status
Single
Married
Annulled
Weight [Kg]
Hair Color
Separated
Widowed
Divorced
Built
Complexion
Place of Birth
Distinguishing Marks
Date of Birth
[DD-MMM-YYYY e.g. 01 JAN 1990]
Occupation
APPLICANT’S ACR I-CARD CLAIM STUB
Applicant’s Name [Last Name, First/Given Name, Middle Name (Please leave a box after each name)]
ACR Number
Visa Type
[IF THE ACR I-CARD IS CLAIMED BY AN AUTHORIZED REPRESENTATIVE, PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS.]
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