Important Reminders

Your appointment is on Wednesday, Oct 12, 2016 at 15:00 - 16:00.

Please be at DFA NCR South (Alabang) at least thirty (30) minutes before
your scheduled appointment.

Please make sure you have prepared all the requirements.

Be ready with both the original and photocopies of your documents
when you appear for personal appearance. Application processing
may be delayed if applicants are not ready with copies of their
documents once inside the data capturing site.

For your NSO certificate requirements, you may call (02) 737-1111. Nationwide
delivery within 3-4 days.

Kindly print your application form (with barcode) in A4-size paper.

You must have a printed application form to show and submit at your
chosen application site.
APPOINTMENT DETAILS: Republic of the Philippines
WCS-RRR-LVJZ-PPT-DORev. October2015
DFA NCR South (Alabang)
DEPARTMENT OF FOREIGN AFFAIRS
Wednesday, Oct 12, 2016
15:00 - 16:00 PASSPORT APPLICATION FORM
THISAPPLICATION FORM IS NOT FOR SALE.PLEASEDO NOT LEAVEANY SPACES BLANK, INDICATE N/A
IF NOT APPLICABLE.PROVIDING FALSE STATEMENTS IN PASSPORT APPLICATIONSIS PUNISHABLE BY
LAW (R.A. 8239).

_D_E_L__A_ _C__R_U_Z____________________________
B__E_B__O_T_____________________________________
 LAST NAME/ APELYIDO FIRST NAME/ PANGALAN (Jr./II/III)

_L_O__Z_A__D_A____________________________________
P__H__I_L__I_P__P__I_N__E_S__ __/_L__E_G__A__Z_P__I_
__C__I_T__Y_________
MIDDLE NAME/ GITNANG PANGALAN PLACE OF BIRTH/ POOK NG
KAPANGANAKAN

____N__O_V__E_M__B_E__R_____ / ____2_3_____ / ___1_9__7_8____

GENDER/ KASARIAN MALE FEMALE
Month Day Year
DATE OF BIRTH/ PETSA NG KAPANGANAKAN
(Ex.: March8, 2010)

Civil Status: Single Married Widow/er Legally Separated

Annulled
Complete Address: P_-_2_ _B_R_G_Y_._ _M_A_R_I_N_I_G_ _CA_B_U_Y_A_O_,_
_L_A_G_U_N_A________________________ Tel. No.:____________________ Present
Occupation:
E_L_E_C_T_R_I_C_I_A_N_____________________________________________ Mobile
No.:+_0_9_1_8_4_2_7_3_6_9_3______
Work Address: _N_A_K_P_IL_ _S_T_R_E_E_T_ _M_A_L_A_T_E_
_M_A_N_I_L_A__________________________________ Tel.
No.:+_9_6_6_5_3_3_8_9_7_4_4_9________
E-mail Address:
A_T_A_N_A_C_I_O___E_M_Y_L_Y_@_Y_A_HO_O_._C_O_M_._P_H_________________________
_____________________________________
Name of Wife /Husband: M_I_C_H_E_L_L_E_ _F_O_L_I_E_N_T_E_ _D_EL_A_
_C_R_U_Z___________________________ Citizenship: P_H_L_______________
Name of Father: P_O_R_F_E_R_I_O_ _A_V_I_N_I_O_N_ _D_E_L_A_
C_R_U_Z___________________________________ Citizenship: P_H_L_______________
Maiden/Singlename of Mother: T_E_R_E_S_I_T_A_ _M_A_N_G_A_M_PO_ _D_E_L_A_
_C_R_U_Z_____________________ Citizenship: P_H_L_______________

Citizenship Acquired By:

Birth Election Marriage Naturalization R.A. 9225 Others
_______________________

Are you a holder of a foreign N Have you ever been Yes No

issued a Philippine
passport? Yes If Yes, from _ o
_ ______
Passport?
A_
what If Yes, latest Passport _F
country?_________________ Number? _ _M_A_N_I_L_A
_ _______E_B_4_2_4_2_4_1 _
_0 _
Date of issue: ____1_2_-
_0_8_-_2_0_1_1____
Place of issue :
 (For applicants below 18 years old ONLY)
Name of minors travelling companion:
________________________________________________________________
Companions relationship: _________________________ Contact Number:
__________________________________
I SOLEMNLY SWEAR that 1) I am a Filipino citizen. 2) The information I provided
in this application are true and correct. 3) The supporting documents attached are
authentic. 4) I am aware that under the law, I am allowed to hold only one Philippine
passport at any given time.5) I am aware that making false statements in passport
application, furnishing falsified or forged documents in support thereof are punishable by
law.
______________________________________________
Signature of Applicantor Legal Guardian (for minor applicants)

ORGAN DONATION (Optional)

In case of death, I hereby donate [ ] Any organ / tissue [x] Specific organ N_/_A__________________
to save other people.
Please immediately notify my family at mobile / tel. no. M_I_C_H_E_L_L_E_ _F_._ _D_E_L_A_
_C_RU_Z_/_ _+_0_9_1_8_.

FOR USE OF THE DEPARTMENT OF FOREIGN AFFAIRSONLY. PLEASE DO NOT WRITE

BELOW THIS LINE.

REMARKS:

Processor: Encoder: Signing Officer: Transmission Officer:

RECEIVED CANCELLED RECEIVED NEW
PASSPORT: PASSPORT:
FOR ADMINISTRATIVE
USE ONLY:
For more details please visit www.dfa.gov.phorwww.passport.gov.ph
REQUIREMENTS FOR FIRST TIME PASSPORT APPLICANTS
Personal appearance Confirmed appointment Duly accomplished application Additional Requirements
form may be downloaded from the For married
DFA website, www.dfa.gov.ph women:
Birth Certificate (BC) in Security Paper (SECPA) issued Marriage Contract (MC) in Security Paper issued by
by the Philippine Statistics Authority (PSA) or Certified PSA or original and photocopy of
True Copy (CTC) of BC issued by the Certified True Copy of MC issued
the Local Civil Registrar (LCR) duly authenticated by the Local Civil Registrar and
by PSA. Transcribed BC from the duly authenticated by PSA. Transcribed MC
LCR is required when entries in PSA BC from the LCR is required when entries
are blurred or unreadable. Report of in PSA MC are blurred or
Birth duly authenticated by PSA is unreadable. Report of Marriage duly authenticated
required if born abroad. by PSA is required if married abroad.
One (1) pictured ID and two (2) Original and photocopy of Commission of Filipinos
supporting documents to prove identity if Overseas (CFO) Guidance and Counseling Certificate of Attendance
necessary (Please refer to list of (required for women with foreign national husband).
Acceptable IDs and Supporting Documents)
In Case of No Birth Record: Applicants who availed of Dual Citizenship under RA
If born in or after 1950 (January 9225
1, 1950 or after): Identification Certificate from the Bureau of Immigration
Apply for the delayed registration of birth Oath of
at the local civil registry office Allegian
located at the place of birth ce Order of
of applicant Approva
Submit authenticated Birth Certificate from PSA and l
supporting public document/s upon the discretion Aliens who have elected Filipino citizenship
of the processor or Consular Officer, with Identification Certificate from the
correct date and place of birth (i.e. Bureau of
Form 137, Voters Registration Record, Baptismal Immigration Oath of
Certificate with readable dry seal or NCMF Allegiance
Certificate with photo and readable dry
seal, for Muslim applicants) If born before Affidavit of Election of Philippine Citizenship
1950 and below (December 31, 1949 Aliens who has been naturalized
and below): Identification Certificate from the
Certificate of Non-availability of Birth Record from Bureau of
PSA Immigration Oath of
Notarized Joint Birth Affidavit of Two Disinterested
Persons Allegiance
Any public document with correct full name,
date and place of birth (i.e. Baptismal
Certificate with readable dry seal or
NCMF Certificate with photo and readable dry
seal, for Muslim applicants)
For Minor Applicants (bel ow 18 years old)
Confirmed appointment (except Original Birth Certificate (BC) of minor in Security Paper
for 1 issued by PSA or Certified True
year old Copy of BC issued by the LCR duly
and below) authenticated by PSA. Transcribed BC from
Personal appearance of the LCR is required when entries
the minor in PSA BC are blurred or unreadable.
applicant Report of Birth duly authenticated by
PSA is required if minor was
born abroad.
 Personal appearance of either parent, PSA Marriage Contract, and valid Document of identity with photo, if minor is
passport of parents (if minor is 8-17 years old (for first time
a legitimate child) / & renewal applicant) such as School I.D. or Form
Personal appearance of mother and proper ID or valid 137 with readable dry seal. For
passport of mother (if minor minor applicants who never attended school,
is an illegitimate child) Original and
a Notarized Affidavit of Explanation executed
photocopy of valid passport of
by either parent (if minor is
the person traveling with the a legitimate child) / by mother
minor (if minor is an illegitimate child)
detailing the reasons why the child is
not in school, is required
Additional Requirements Foundling:
If minor is not traveling with either Certificate of foundling authenticated by PSA
parent or alone: DSWD Clearance
Personal appearance of either parent (if minor is a legitimate child) / of mother (if minor is an illegitimate child) Passport of the person who found the
Affidavit of Support and Consent (ASC) executed applicant
by either parent indicating the name Letter of authority or
of the traveling companion and relationship to endorsement from DSWD for
the minor. If minor will be traveling the issuance of passport
alone, ASC must be executed by Legally adopted:
either parent, stating that his/her child Original and Certified True Copy (CTC) of
will be traveling alone. If minor is the PSA amended Birth Certificate after
illegitimate, mother should execute the ASC.
Original and photocopy of DSWD Clearance. There is adoption
no need to secure a DSWD Certified True Copy (CTC) of the
Clearance if the minor traveling abroad Court Decision or Order on
has parents who are in the Foreign Adoption and Certificate of Finality
Service or living abroad or are DSWD clearance for minor applicant, if
immigrants, provided he / she is traveling with the person other
holding a valid pass such as a than the adopting parents In case
dependents visa / pass / identification card the applicant is for adoption
or permanent resident visa / pass by foreign parents:
/ identification card which serves as Certified True Copy of the Court Decree
proof that he / she is living of Abandonment of Child
with parents abroad. PSA Death Certificate of the childs parents
If both parents are abroad: or the Deed of Voluntary Commitment
Affidavit of Support and Consent (ASC) executed executed after the birth of the
by either parent indicating the name child
of the traveling companion (authenticated by Endorsement of child to the Inter-country Adoption
the nearest Philippine Embassy or Consulate General). Board by the DSWD
If minor is illegitimate, mother should
Authenticated Birth or Foundling Certificate
execute the ASC.
Special Power of Attorney (SPA) with an Minor applicant whose
attached photocopy of either parents valid parents are annulled /
passport (authenticated by the nearest Philippine divorced:
Embassy or Consulate General) authorizing a Court order awarding guardianship of the
representative in assisting the child to minor applicant or substitute parental
apply for a passport. If minor authority DSWD Travel Clearance
is illegitimate, mother should execute the SPA. PSA Marriage Certificate with
Original and photocopy of DSWD Clearance. There is annotation on nullity or
no need to secure a DSWD annulment decree Minor
Clearance if the minor traveling abroad applicant whose mother is
has parents who are in the Foreign likewise a minor:
Service or living abroad or are Personal appearance of mother and maternal grandparent/s
immigrants, provided he / she is PSA Birth Certificate of minor applicant and
holding a valid pass such as a mother
dependents visa / pass / identification card
Affidavit of Support and Consent executed by
or permanent resident visa / pass
the maternal grandparent/s indicating the name
/ identification card which serves as
proof that he / she is living of the traveling companion
with parents abroad. DSWD Clearance if minor will be traveling
Proper ID of the duly with the person other than the
authorized representative (Please refer maternal grandparent/s
to List of Acceptable Proof of identity of mother and maternal
IDs) If minor is grandparent/s (Please refer to List of
legitimated by subsequent marriage Acceptable IDs)
of parents:
Authenticated Birth Certificate from PSA with annotation For Muslim applicants (same
regarding new status as legitimated and general requirements stated above)
the full name of the child If For late registered Muslim
minor is illegitimate but acknowledged by applicants:
father: Certificate of Tribal Affiliation from the National Commission
Birth certificate from PSA reflecting surname of on Muslim Filipinos (NCMF)
father with Affidavit of Acknowledgement
and Consent to use surname of For converts who would like to use
father Orphaned minor applicant: their Muslim name:
Authenticated Death Certificates of parents from PSA
Annotated Birth Certificate (BC) in Security Paper (SECPA) issued
Court order awarding guardianship of the orphaned
minor applicant or substitute parental authority by PSA bearing the Muslim
under Article 214 & 216 of the name NCMF Certificate of Conversion
Family Code
DSWD Clearance
Abandoned minor applicant:
Court order awarding guardianship of the abandoned
minor applicant or substitute parental authority
DSWD Travel Clearance
REQUIREMENTS FO R RENEWAL OF PASSPORT
Personal appearance Confirmed Appointment Duly accomplished application form may be downloaded from the DFA website,
www.dfa.gov.ph
Most recent passport (expiring or expired) One (1) pictured ID and two (2) supporting
documents to prove identity if necessary (Please refer to List of Acceptable IDs
and Supporting Documents)
Brown Passport or passports issued prior to Machine Readable Passport (MRP) issued in the year
01 May 1995: 2007:
Bring original brown passport and photocopy of passport Bring original passport and photocopy of first and
pages 1,2,3,4 and last page last page of passport
Birth Certificate in Security Paper issued by PSA Birth Certificate (BC) in Security Paper (SECPA) issued
or Certified True Copy of BC by the Philippine Statistics Authority (PSA) or Certified
issued by the Local Civil Registrar True Copy (CTC) of BC issued by
duly authenticated by PSA, to determine the Local Civil Registrar (LCR) to
complete middle name. Transcribed Birth Certificate determine complete place of birth. Transcribed
from the LCR is required when Birth Certificate from the LCR is required
entries in PSA Birth Certificate are blurred or unreadable. when entries in PSA Birth Certificate
Report of Birth duly authenticated by are blurred or unreadable Electronic Passport
PSA if born abroad Green Passport (E-passport)
or passports issued after 01 May Bring original e-passport and photocopy of page 2 (data
1995:
Bring original green passport and photocopy of the data page) of passport
page and last page of passport
For women who would change their civil For minor applicants, requirements for first
status from single to married:
Marriage Contract (MC) in Security Paper issued time minor applicants are still
by
of
PSA
MC
or
issued
Certified
by
True
the
Copy
Local
prescribed, in addition to the passport
Civil Registrar and duly authenticated by PSA. of minor.
Transcribed Marriage Contract from the LCR
is required when entries in PSA
Marriage Contract are blurred or unreadable. Report For Muslim Applicants(same general requirements
of Marriage duly authenticated by PSA
if married abroad stated above)
For spouse of foreign national who would For converts who would like to use
change their civil status from single their Muslim name:
to married: Annotated Birth Certificate (BC) in Security Paper (SECPA) issued
Marriage Contract (MC) in Security Paper issued by PSA bearing the Muslim
by PSA or Certified True Copy name National Commission on Muslim Filipinos
of MC issued by the Local (NCMF) Certificate of Conversion
Civil Registrar and duly authenticated by PSA.
Transcribed Marriage Contract from the LCR For naturalized Filipinos or applicants that elected
is required when entries in PSA Philippine Citizenship and holder of brown or
Marriage Contract are blurred or unreadable. Report of green
Marriage duly authenticated by PSA if

Original
married
and
abroad
photocopy of Commission of

pBausrsepauo rot f Immigration Identification Certificate
Filipino Overseas (CFO) Guidance and
Counseling Certificate of Attendance For
married women who would like to Certificate of Naturalization
revert to their maiden name:
 Birth Certificate (BC) in Security Paper (SECPA) issued
by PSA or Certified True Copy
of BC issued by the Local Election of Filipino Citizenship / Oath of
Civil Registrar and duly authenticated by PSA. Allegiance
Transcribed Birth Certificate from the LCR
is required when entries in PSA Applicants who re-acquired Filipino Citizenship
Birth Certificate are blurred
Birth duly
or
authenticated by
unreadable. Report
PSA
of
is
Identification Certificate
required if born abroad Oath of Allegiance Order of Approval
If already widowed: Death Certificate in Security Paper (SECPA)
issued by PSA of the deceased Report of Birth (for those born abroad)
husband
If marriage is annulled: Certified True Copy
of annotated PSA Marriage Contract and
Court Order effecting the annulment. If divorced:
Certified True Copy of the Divorce Decree
duly authenticated by the Philippine Embassy
or Consulate where the divorce was obtained
or by the concerned foreign diplomatic
or consular mission in the Philippines.
Original and CTC of Phil.
Court recognition of foreign divorce decree must
also be present and the PSA
MC with the annotation of the
Divorce Decree.
REQUIREMENTS FOR REPLACEMENT OF LOST PASSPORTS LIST OF ACCEPTABLE IDS (At least 1
Personal appearance of the following):
Confirmed Appointment for applicants with expired passports Government-issued IDs such as digitized SSS ID,
and issued travel documents (lost-valid passport Drivers License, GSIS E-card, PRC ID, IBP ID, UMID, Voters
applicants may proceed directly to the Consular Records ID, and Senior Citizens ID
Division at DFA-Aseana without an appointment)
Duly accomplished application form may be Other acceptable picture IDs include old College
downloaded from the DFA ID, Alumni ID, or old Employment
IDs
website, www.dfa.gov.ph Requirements for
LIST OF SUPPORTING DOCUMENTS (Old documents issued
the first time applicants at least one year prior to
date of application that show correct name,
is still prescribed date and place of birth, picture,
In case passport was lost and cannot and signature of applicant, at least 2
of the following):
be found:
Submit Notarized Affidavit of Loss (with detailed explanation on
when, where and how passport got PSA Marriage Contract

If
lost).
the lost
Land Title
passport
still valid,
is
submit Police
Seamans Book
Report. Photocopy Elementary or High School Form 137
of first or Transcript of Records with readable
page
lost
of
passport
dry seal Government Service Record
(if available) NBI Clearance
There will be a 15-day clearing period prior to
the processing of application for Police Clearance
replacement of
passport was
a
already
lost valid passport In
declared lost
case
by Barangay Clearance
the
and
applicant
returned
but
to
eventually was
him/her: Notarized
found Readable SSS-E1 Form or Microfilmed copy
of SSS-E1 Form
Affidavit of Retrieval (with detailed explanation on
when,
found)
where and how passport was Voters Certification, List of Voters and
Voters Registration Record (for newly issued
Original and photocopy VRR, please attach receipt)
of first
and last School Yearbook
page of
passport In case Digitized Postal ID
of mutilated
or damaged
passports:
Notarized Affidavit of Mutilation (with detailed explanation
on when, where and how passport
got mutilated or damaged)
Original and photocopy of
first and last
page of mutilated or
damaged passport In case
applicant was issued a
Travel Document: Original
Travel Document
Notarized Affidavit of Explanation Regarding Issuance of
Travel Document (with detailed explanation on
when, where and why applicant was issued
a travel document)
Original and photocopy of first and last
page of cancelled passport (if passport is
still in the possession of the
applicant)
There will be a 15-day clearing period prior to
the processing of application for replacement
of a lost valid passport
REMINDERS Passport shall be released to an immediate
Personal appearance is required for all applicants family member only with proper authorization
Confirmed appointment is required for all applicants letter and proof of identity. Immediate family members
except senior citizens, infants & minors include father, mother, brother, sister, spouse
below 1 year old and OFWs. For OFWs, sufficient and children of legal age. Passport of
proof must be submitted such as a minor applicant shall be released
valid employment contract or OEC. to parents only or to an
authorized representative with Special Power of Attorney
Earrings & contact lenses are not allowed & Affidavit of Support and Consent.
during data capturing. Smiling with visible Passports unclaimed after 6 months will be
teeth is also not allowed. cancelled per Department Order No. 37-03.
Check all data in the computer monitor Check all data in the received e-passport
& in the Enrolment Certificate before upon release.
signing.
PASSPORT FEES: Apply for your passport early, prepare requirements
Regular Processing (15 working days) : P950.00 before appointment date, non-OFW and Metro
Expedited Processing (07 working days): P1,200.00 Manilabased applicants should secure an appointment
For Replacement of a lost valid passport:
Additional fee of P200.00 for a when applying for a passport, those
lost valid MRRP/MRP or P350.00 for in provinces can apply at the nearest
a lost valid epassport Processing schedule Regional Consular Office or during Mobile
may be changed upon prior notice Passport Service (MPS), OFWs can apply
Number of processing days may vary depending
at the DFA Satellite Office located at
on the location of the Regional
Consular Office where Robinsons Galleria in Ortigas, Quezon City.
the application was filed Do not deal with fixers, avail
of the passport delivery service & take
good care of your passport. For
comments, complaints & assistance, please contact the
Public Assistance Center or the Passport
Directors Office.
REQUIREMENTS ARE BASED FROM R.A.8239 OR THE PHILIPPINE PASSPORT ACT OF
1996 AND ITS IMPLEMENTING RULES AND REGULATIONS.