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REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF FOREIGN AFFAIRS
MANILA
BUY AND GET PASSPORT BY FILLING-UP THE APPLICATION
Customer Entry Form
New      Renewal      Lost Passport
Name:
Last Name * First Name * Middle Name *  
Date of Birth:
*
Gender: Male         Female
Place of Birth
Country: * Province: * City/Municipality: *   
Civil Status : Single Married Widower Separated / Divorce
Name of Spouse:
Last Name
 Middle Name
 First Name
Complete Address in the Philippines:
Tel. No.
Present Occupation
Office Address:
Tel. No.
Purpose of Travel: Tourist Business Immigrant Study Contact Worker Seaman
Others
  Father's Name  
First Name Middle Name Last Name
Citizenship
Mother's Name (Include Maiden Name)
First Name Middle Name Last Name (Maiden)
Citizenship
Click if you are:
Legitimate Illegitimate
Citizenship acquired by:
Birth Election Naturalization
Marriage R.A. 9225
Have you ever been issued a Philippine Passport:
Yes No
If Yes, Passport No.
Date of Issue
Place of Issue
For Minor Applicants:

Name of Travel Companion:

Relationship:
Available IDs / Remarks:
Processing Type: Regular      Rush     
The following items are used for pick-up and delivery of your passport. Please specify your location accurately.
City
Pickup / Delivery Address
Landmarks
Your Contact Information
Full Name :
Mobile Number :
Telephone Number :
Email Address :
Contact Address :
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