Bi Form 2014-00-001 - Consolidated General Application Form For Immigrant Visa
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2BI FORM 2014-00-001 Rev 0
This document may be reproduced and is NOT FOR SALE
CONSOLIDATED GENERAL APPLICATION FORM
IMMIGRANT VISA
FOR
I. APPLICATION INFORMATION
Present Immigration Status
Attach your 2x2 colored photograph
Nature of Application
with white background using
permanent glue in the
Conversion
Amendment
Inclusion
photograph box.
Type of Visa Application
The photograph must be taken
within the last three (3) months
Method of Application
from the date of application.
Personal
Authorized Representative
A scanned photograph is not
BI Accreditation Number
allowed. A photograph of the
applicant wearing eyewear (i.e.
Name of Authorized Representative [Last Name, First/Given Name, Middle Name]
sunglasses, colored contact lenses,
etc.) or headwear is not acceptable.
II. APPLICANT’S TRAVEL INFORMATION
Passport Number
Date of Latest Arrival [DD-MMM-YYYY e.g. 01 JAN 1990]
Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990]
Flight Number
Place of Issuance
Last Day of Authorized Stay [DD-MMM-YYYY e.g. 01 JAN 1990]
III. APPLICANT’S PERSONAL INFORMATION
Last Name
First/Given Name
Middle Name
Other Name(s)/Alias(es)
1
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Gender
Country of Birth
M
F
Citizenship/Nationality
Civil Status
Single
Married
Annulled
Height [cm]
Weight [kg]
Separated
Widowed
Divorced
Profession/Occupation
Contact Number(s) in the Philippines
Email Address
Landline
Mobile
Residential Address in the Philippines
Residential Address Abroad
House/Unit No., Street, Subdivision/Village
House/Unit No., Street, Subdivision/Village
Barangay, Municipality/City
City, State
Province, Zip Code
Country, Zip Code
Name of Spouse [Last Name, First/Given Name, Middle Name]
Other Name(s)/Alias(es)
1
2
Name(s) of Child(ren) and Date(s) of Birth [Last Name, First/Given Name, Middle Name]
1
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Last Name, First/Given Name, Middle Name
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Note: If the applicant has more than two (2) children, use BI Form 2014-00-005 Rev 0.
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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