Form No. 1 - English New Regular Passport Application (Adult)
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1
2Form No. 1 – ENGLISH
NEW REGULAR PASSPORT APPLICATION (Adult)
DEPARTMENT OF FOREIGN AFFAIRS
THIS FORM IS NOT FOR SALE
Office of Consular Affairs
Last Revision: 07 October 2017
INSTRUCTIONS: Please PRINT entries legibly using black or blue
Site: XXXXXXX
Date/Time: Day, DDMon YYYY/0000HR
ink only. Supply the necessary information and indicate “N/A” for
Booking Reference no.:0123456789101112
entries with no answers. Tick (√) boxes as appropriate.
CAPTURE SITE PRE-PROCESSING (Do not write on this part)
APPOINTMENT VERIFICATION:
REMARKS:
PASSPORT APPLICANT’S INFORMATION
1.LAST NAME
2. FIRST NAME
3. MIDDLE NAME or MAIDEN LAST NAME
4. SEX
5. DATE OF BIRTH
6. PLACE OF BIRTH
(ex. 01 Jan 2017)
(For born in the PHL: Municipality/City & Province
MALE
For born outside the PHL: Country)
FEMALE
D D
M M M
Y Y Y Y
8b. DID YOU EVER LOSE YOUR PH
7. CIVIL STATUS
8a.
HOW DID YOU ACQUIRE PHL CITIZENSHIP?
CITIZENSHIP?
YES
NO
8c.ARE YOU CURRENTLY A CITIZEN OF
SINGLE
BY BIRTH
ANOTHER COUNTRY?
YES
NO
MARRIED
8d.IF YES, FROM WHAT COUNTRY?
BY NATURALIZATION
WIDOW/ER
BY RE-ACQUISITION (RA 9225)
8e. HAVE YOU SERVED IN ANY FOREIGN
NULLIFIED /
MILITARY?
YES
NO
BY ELECTION
IF Yes, what country?
ANNULLED
BY LEGISLATION
DIVORCED
APPLICANT’S CONTACT INFORMATION
9a. HOME ADDRESS:
9b. PRESENT ADDRESS:
10. WHERE DO YOU WISH YOUR PASSPORT TO BE DELIVERED?
HOME ADDRESS
PRESENT ADDRESS
11. TELEPHONE/MOBILE NUMBER:
12. e-MAIL ADDRESS:
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