Important Reminders

☐
Your appointment is on Monday, Jan 15, 2018 at 14:00 - 15:00.
Please be at Cagayan De Oro 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
Cagayan De Oro DEPARTMENT OF FOREIGN AFFAIRS
Monday, Jan 15, 2018
14:00 - 15:00 PASSPORT APPLICATION FORM
THISAPPLICATIONFORMIS NOT FORSALE. PLEASEDONOT LEAVEANY SPACES BLANK, INDICATE N/AIF NOT APPLICABLE. PROVIDINGFALSE
STATEMENTS INPASSPORT APPLICATIONSIS PUNISHABLE BY LAW(R.A. 8239).

_______________________________________
BALDOMERO ___________________________________________
FRED VINCENT
LAST NAME/ APELYIDO FIRST NAME/ PANGALAN (Jr./II/III)
____________________________________________
SALARDA ________________________________________________
PHILIPPINES /ILIGAN CITY
MIDDLE NAME/ GITNANG PANGALAN PLACE OF BIRTH/ POOK NG KAPANGANAKAN

____________________
APRIL / __________
30 / ___________
1992 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: BLOCK
________________________________________________________
3, LOT 24, PAULINA HOMES SUBDIVISION, DALIPUGA, ILIGA… Tel. No.:____________________
+632251906
Present Occupation:CIVIL
_______________________________________________________
ENGINEER Mobile No.:_________________
+639561690129
Work Address: ____________________________________________________________
POBLACION, LUGAIT, MISAMIS ORIENTAL Tel. No.:____________________
+632251906
E-mail Address: BALDOMERO.FREDVINCENT@GMAIL.COM
_______________________________________________________________________________________
Name of Wife / Husband: RESAVIC
____________________________________________________
MAQUILING BALDOMERO Citizenship:PHL
_________________
Name of Father: GERRY
___________________________________________________________
FLOREN BALDOMERO Citizenship:PHL
_________________
Maiden/ Single name of Mother:IMELDA
______________________________________________
SAMSON SALARDA Citizenship:PHL
_________________

Citizenship Acquired By:

□ Birth □ Election □ Marriage □ Naturalization □ R.A. 9225 □ Others _______________________
Are you a holder of a foreign passport? □ Yes □ No Have you ever been issued a Philippine Passport? □ Yes □ No
If Yes, from what country?___________________ If Yes, latest Passport Number? _______________________
Date of issue: _________________ Place of issue: __________
(For applicants below 18 years old ONLY)
Name of minor’s travelling companion: ________________________________________________________________
Companion’s 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 Applicant or 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. RESAVIC
___________________________.
BALDOMERO/ +63921303…

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

REMARKS:

Processor: Encoder: Signing Officer: Transmission Officer:

RECEIVEDCANCELLED PASSPORT: RECEIVEDNEWPASSPORT:
FOR ADMINISTRATIVE USE ONLY:
For moredetailsplease visit www.dfa.gov.phor www.passport.gov.ph
Important Reminders

☐
Your appointment is on Monday, Jan 15, 2018 at 14:00 - 15:00.
Please be at Cagayan De Oro 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
Cagayan De Oro DEPARTMENT OF FOREIGN AFFAIRS
Monday, Jan 15, 2018
14:00 - 15:00 PASSPORT APPLICATION FORM
THISAPPLICATIONFORMIS NOT FORSALE. PLEASEDONOT LEAVEANY SPACES BLANK, INDICATE N/AIF NOT APPLICABLE. PROVIDINGFALSE
STATEMENTS INPASSPORT APPLICATIONSIS PUNISHABLE BY LAW(R.A. 8239).

_______________________________________
BALDOMERO ___________________________________________
RESAVC
LAST NAME/ APELYIDO FIRST NAME/ PANGALAN (Jr./II/III)
____________________________________________
MAQUILING ________________________________________________
PHILIPPINES /PLARIDEL, MISAMIS…
MIDDLE NAME/ GITNANG PANGALAN PLACE OF BIRTH/ POOK NG KAPANGANAKAN

____________________
NOVEMBER / __________
11 / ___________
1991 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: BLOCK
________________________________________________________
3, LOT 24, PAULINA HOMES SUBDIVISION, DALIPUGA, ILIGA… Tel. No.:____________________
+639213031730
Present Occupation:STUDENT
_______________________________________________________ Mobile No.:_________________
+639213031730
Work Address: ____________________________________________________________ Tel. No.:____________________
E-mail Address: BALDOMERO.RESAVIC@GMAIL.COM
_______________________________________________________________________________________
Name of Wife / Husband: FRED
____________________________________________________
VINCENT SALARDA BALDOMERO Citizenship:PHL
_________________
Name of Father: VICTOR
___________________________________________________________
JR TORMIS MAQUILING Citizenship:PHL
_________________
Maiden/ Single name of Mother:REBECCA
______________________________________________
BILLONES MARTINEZ Citizenship:PHL
_________________

Citizenship Acquired By:

□ Birth □ Election □ Marriage □ Naturalization □ R.A. 9225 □ Others _______________________
Are you a holder of a foreign passport? □ Yes □ No Have you ever been issued a Philippine Passport? □ Yes □ No
If Yes, from what country?___________________ If Yes, latest Passport Number? _______________________
Date of issue: _________________ Place of issue: __________
(For applicants below 18 years old ONLY)
Name of minor’s travelling companion: ________________________________________________________________
Companion’s 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 Applicant or 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. FRED
___________________________.
VINCENT BALDOMERO/ +639…

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

REMARKS:

Processor: Encoder: Signing Officer: Transmission Officer:

RECEIVEDCANCELLED PASSPORT: RECEIVEDNEWPASSPORT:
FOR ADMINISTRATIVE USE ONLY:
For moredetailsplease visit www.dfa.gov.phor www.passport.gov.ph
Important Reminders

☐
Your appointment is on Monday, Jan 15, 2018 at 14:00 - 15:00.
Please be at Cagayan De Oro 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
Cagayan De Oro DEPARTMENT OF FOREIGN AFFAIRS
Monday, Jan 15, 2018
14:00 - 15:00 PASSPORT APPLICATION FORM
THISAPPLICATIONFORMIS NOT FORSALE. PLEASEDONOT LEAVEANY SPACES BLANK, INDICATE N/AIF NOT APPLICABLE. PROVIDINGFALSE
STATEMENTS INPASSPORT APPLICATIONSIS PUNISHABLE BY LAW(R.A. 8239).

_______________________________________
BALDOMERO ___________________________________________
JIREH VIC
LAST NAME/ APELYIDO FIRST NAME/ PANGALAN (Jr./II/III)
____________________________________________
MAQUILING ________________________________________________
PHILIPPINES /ILIGAN CITY
MIDDLE NAME/ GITNANG PANGALAN PLACE OF BIRTH/ POOK NG KAPANGANAKAN

____________________
DECEMBER / __________
09 / ___________
2015 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: BLOCK
________________________________________________________
3, LOT 24, PAULINA HOMES SUBDIVISION, DALIPUGA, ILIGA… Tel. No.:____________________
+639561690129
Present Occupation:NONE
_______________________________________________________ Mobile No.:_________________
+639561690129
Work Address: ____________________________________________________________ Tel. No.:____________________
E-mail Address: BALDOMERO.FREDVINCENT@GMAIL.COM
_______________________________________________________________________________________
Name of Wife / Husband: ____________________________________________________ Citizenship: _________________
Name of Father: FRED
___________________________________________________________
VINCENT SALARDA BALDOMERO Citizenship:PHL
_________________
Maiden/ Single name of Mother:RESAVIC
______________________________________________
MARTINEZ MAQUILING Citizenship:PHL
_________________

Citizenship Acquired By:

□ Birth □ Election □ Marriage □ Naturalization □ R.A. 9225 □ Others _______________________
Are you a holder of a foreign passport? □ Yes □ No Have you ever been issued a Philippine Passport? □ Yes □ No
If Yes, from what country?___________________ If Yes, latest Passport Number? _______________________
Date of issue: _________________ Place of issue: __________
(For applicants below 18 years old ONLY)
FRED VINCENT BALDOMERO
Name of minor’s travelling companion: ________________________________________________________________
Companion’s relationship: _________________________ Contact Number: +639561690129
FATHER __________________________________

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 Applicant or 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. FRED
___________________________.
VINCENT BALDOMERO/ +639…

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

REMARKS:

Processor: Encoder: Signing Officer: Transmission Officer:

RECEIVEDCANCELLED PASSPORT: RECEIVEDNEWPASSPORT:
FOR ADMINISTRATIVE USE ONLY:
For moredetailsplease visit www.dfa.gov.phor www.passport.gov.ph