May 22, 2017

COMMISSIONER JAIME H. MORENTE

Office of the Commissioner
Bureau of Immigration
Magallanes Drive, Intramuros
Manila

Dear Sir:

I am writing to your office in connection with my request for travel records. My current
Philippine passport has the following details:

Passport No. :
Full name :
Birth date :
Sex :
Nationality :
Place of birth :
Date issued :
Valid until :
Issuing authority :

The travel records I am requesting is for the year ______. The purpose of my request is
to use my travel records as one of the bases of the petition for declaration of nullity of
marriage, which I will file with the _______________. Considering that my travel history
is a vital document for my cause of action and that my petition is yet to be filed, I do not
have a court order or a specific branch of __________ as of writing.

Furthermore, my old passport, where my international travel history was recorded, was
lost in _______ when our house in ___________ was flooded. Due to this incident and
the fact that it was ____ years ago when I lost said old passport, I could no longer recall
the passport number and validity period which covers my travel history for the year
__________. This is the reason why I could not provide a photocopy of the old passport
subject of my request as well as the departure and arrival stamps for the year ______.

To attest to the truthfulness of my allegations, I have executed an Affidavit of Loss for

my old passport.

In support of my request, the following documents are attached to this letter:

1. Duly accomplished application form (BI Form 2014-13-006 Rev 0);

2. Photocopy of my current passport bio page;
3. Affidavit of Loss.

I trust that the above are sufficient for the purpose for which my request for travel
records is made. I appreciate your assistance on this matter.

Respectfully,

________________