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BI FORM 2014-08-006 Rev 0

This document cannotbereproducedand is NOT FOR SALE

APPLICATION FORM FOR ALIEN CERTIFICATE OF

REGISTRATION IDENTITY-CARD (ACR I-CARD)

Name of Spouse [Last Name, First/Given Name, Middle Name]

Spouse’s Nationality

ARE YOU PLANNING TO LEAVE THE COUNTRY WITHIN THIRTY (30) DAYS UPON ISSUANCE OF ACR I-CARD?

YES

RP/

SRC Number

RP/SRC Date of Issuance

[DD-MMM-YYYY e.g. 01 JAN 1990]

RP/SRC Type

Expiry Date/Valid Until

[DD-MMM-YYYY e.g. 01 JAN 19900]

Father’s Name [Last Name, First/Given Name, Middle Name]

AFFIDAVIT FOR PERSONS 14 YEARS OF AGE OR OVER

I have read the above statements or have had them read to me, and do hereby swear (or affirm) that these statements are

true and complete to the best of my knowledge and belief; furthermore, that I have not filed any application for this purpose still

pending or not given due course in another Immigration office.

___________________________

_____________________________________

(Signature of Applicant)

(Signature of Witness in case

Applicant does not know how to

TIN : ________________________________

write)

SUBSCRIBED

AND

SWORN

before

this

_______

day

__________________________

_____________________________________;

Affiant/Applicant

exhibiting

his/her

Passport/CTC

No.

_________________________ issued on _________________________ at __________________________________________.

_____________________________________

(Registration Officer)

_____________________________________

(Official Designation)

AFFIDAVIT FOR PARENT OR GUARDIAN ONLY

I am the parent of/guardian of/person responsible for the above-named alien who is under 14 years of age/insane and have

made the above allegations for him/her. I have read or have had the same read to me, and do hereby swear (or affirm) that they

are true and complete to the best of my knowledge, information or belief; furthermore, that I have not filed any application for this

purpose in behalf of the above-named alien still pending or not given due course in another Immigration office.

________________________________

_____________________________________

(Signature of Witness)

(Signature of Parent, etc.)

TIN : ________________________________

SUBSCRIBED

AND

SWORN

before

this

_______

day

__________________________

_____________________________________;

Affiant/Applicant

exhibiting

his/her

passport/CTC

No.

_________________________ issued on _________________________ at __________________________________________.

_____________________________________

(Registration Officer)

_____________________________________

(Official Designation)

DOCUMENTS PRESENTED: (*) Document to be retained and incorporated in the records.

1. *Old ACR No.