Immigrant Visa Application Form (Philippines)
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2FOREIGN SERVICE OF THE PHILIPPINES
__________________________
___________________________________
__________________________
___________________________________
__________________________
FA FORM NO. 3
APPLICATION FOR IMMIGRANT VISA
PLEASE TYPE OR PRINT ANSWERS LEGIBLY IN THE SPACES PROVIDED (IF NOT APPLICABLE WRITE (N/A)
1.
NAME AS WRITTEN IN PASSPORT
APPLICANT'S
PHOTOGRAPH
2 in. x 2 in.
2.
LAST NAME (surname or family name)
1. Picture taken within the past
6 months
3.
FIRST NAME (all given names)
5. SEX
2. Front View
FEMALE
MALE
3. Without eyeglasses
4. Name and Signature on front
4.
MIDDLE NAME
6. CITIZENSHIP
of photograph
7.
DATE OF BIRTH (dd/mm/yyyy)
8. PLACE OF BIRTH (city, state or province, country)
Staple or paste photo here
9.
CIVIL STATUS
FOR OFFICAL USE ONLY
SINGLE
MARRIED
WIDOWED
DIVORCED
SEPARATED
IMMIGRANT VISA NO.
10. IF MARRIED, NAME AND ADDRESS OF SPOUSE
VISA SHEET NO.
11a. TRAVEL DOCUMENT TYPE
11b. PASSPORT / TRAVEL DOCUMENT NUMBER
PASSPORT
TRAVEL DOCUMENT
DATE OF ISSUE
11c. PLACE OF ISSUE (city, state or province,country)
DATE OF EXPIRY
11d. DATE OF ISSUE (dd/mm/yyyy)
11e. DATE OF EXPIRY (dd/mm/yyyy)
11f. VISA REQUESTED
12. SUPPORTING DOCUMENTS
IMMIGRANT VISA CLASSIFICATION
NON-QUOTA IMMIGRANT
QUOTA IMMIGRANT
Quota Immigrant
Quota No. _____________________
13. INTENDED PORT OF ENTRY
14. EXPECTED DATE OF ARRIVAL IN THE PHILIPPINES
Non-Quota Immigrant under Section
15. HOME ADDRESSES FOR THE PAST 5 YEARS*
_______________ of the Philippine
(include apartment number, street, city, state or province, postal zone and country)
Immigration Act of 1940 as amended.
ADDRESS
INCLUSIVE DATES
VISA ISSUED TO
CITIZENSHIP
BEARER'S TRAVEL DOCUMENT
Type ___________________________________
No. ___________________________________
16. CURRENT HOME TELEPHONE NUMBER
17. E-MAIL ADDRESS
Date of Isssue __________________________
Date of Expiry __________________________
18a. PRESENT OCCUPATION / RANK / POSITION
18b. Since
Issuing Authority _______________________
19. WORK ADDRESS (include no., street, city, state or province, postal zone, country)
_______________________________________
VISA APPROVED/DENIED BY
20. WORK TELEPHONE NUMBER
21. WORK FAX NUMBER
22. REFERENCES AND/OR IMMEDIATE RELATIVES IN THE PHILIPPINES
ADDRESS
RELATIONSHIP
NAME
SERVICE NO.
FEE
O.R. NUMBER
RECEIVER
CASHIER
LOL
23. DATE OF APPLICATION
24. SIGNATURE OF APPLICANT
PROCESSOR
SCRIPTER
ENCODER
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