‘anos [NBI Online Aoptaion REPUBLIC OF THE PHILIPPINES DEPARTMENT OF JUSTICE [NATIONAL BUREAU OF INVESTIGATION NBI CLEARANCE APPLICATION rerenencenowacn FORM WES6ZTM4 Thursday, January 29, 2015 (AM) Valid Until February 13, 2015 "APPLICANT TYPE 1. 1O PRESENTED 2, PURPOSE TYPE {3 PURPOSE APPLICATION NeW ScHOOLLD Local LOCAL EMPLOYMENT asic nFoRNaTION 6. PANILY NAME 6, HUSBAND FAMILY NAME (FOR WAFRIED WOMAN ONLY) MANON.OG. 7. GIVEN NAME 8, MIDOLE NAME JUVEN LoMoLio ®. NICKNANE 10, OTHER NAMEJALSO KNOW AS “1, DATE OF BIRTH 1. BIRTH PLACE orizatge2 ‘TABOC SUR, OROQUIETA GITY 48, CINZENSHIP “4, GENDER 18. CW STATUS FILIPINO MALE SINGLE 18, SPOUSE 17, BIRTH PLACE 48, PRESENT ADDRESS CAMP ALAGAR, LAPASAN, CAGAYAN DE ORO CITY 18. CONTACT UNGER. 20. EMAIL ADDRESS 21. IDENTIFYING MARKS oo7ssosse71 juven_anonog@yahoo.com MOLE ON THE LEFT SIDE [BEHIND THE MOUTH oorioNAL wroRNATION. 72, HEIGHT 23, WEIGHT | 24. COMPLEXION 25, RELIGION 70 0 FAR EVANGELICAL, 28, EDUCATIONAL ATTAINVENT 27, OGCUPATION COLLEGE LEVEL NONE PARENTS INFORNATION 28, NAME OF FATHER 29, FATHER BIRTH PLACE. VINCENTE MANON-0G ‘OROQUIETA CITY 30, NANE OF WOTHER 931, MOTHER BIRTH PLACE, DALLY MANON-0G ‘OROQUETA CITY nd cerca nconeat "ant hve ad rd rerio he unless en nb elon gerne ied om 26, O8TE 87, SIGNATURE © 2015 Al Rights Reserved ipcearance ni gv piprinis7id=MS8252380838,efno= WESEZTME "