Philippines Visa Application Form (Page 2 of 2) in pdf

Reference and/or immediate relative in the Philippines:

Name: _____________________________

Address: ______________________________

Phone/e-mail: __________________________

Contact person in Australia:

Name: _____________________________

Address: ______________________________

Phone/e-mail: __________________________

I agree that any false or misleading statement and submission of fraudulent documents will result in

•

the refusal of my visa.

I agree to submit documents in addition to those submitted as indicated in the list of requirements, if

•

required.

I agree that submission of complete documentary requirements is not a guarantee that a visa will be

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issued.

I agree that since my application will go through the visa procedure, the processing fee that I will pay

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will not be refunded even if no visa is issued to me.

I agree that the possession of a visa does not automatically entitle the bearer to enter the

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Philippines upon arrival at any port of entry if he or she is found inadmissible.

I agree that I may enter the Philippines at the port of entry designated by the Philippine Immigration

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Authorities and under the conditions imposed by those authorities.

I have read and understood all the questions in this application form and the answers I have

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furnished on this form are true and correct to the best of my knowledge and belief.

Signature of Applicant Above Printed Name

SUBSCRIBED AND SWORN TO before me this ___________ day of _____________ 20__

at ______________________________, Australia.

Consular Officer

(or Justice of the Peace if sent by mail)

FOR OFFICIAL USE ONLY

Republic of the Philippines

Embassy of the Philippines

Canberra, Australia

SEEN

Visa No. ___________________

For the journey to the Philippines

Of ___________________________________

Includes: _____________________________

Date Granted:__________________________

Valid for Single/Multiple entry

Valid for entry until: _____________________

Issued under Section _________________

of the Philippine Immigration Act of 1940;

as amended under Classification ______

_________________________________

Service No. : _______________________

Good for a stay in the Philippines not exceeding

Fee

: _______________________

_____________________________________

Paid under OR No. __________________

______________________________________

CONSULAR OFFICER

Processed/LOL Cleared by:_____________

PASSPORT & DOCUMENTS RECEIVED BY:

Printed Name: _________________________ Signature: ____________________ Date: ___________

Philippines Visa Application Form Page 2

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