PHILIPPINE CONSULATE GENERAL

Geneva, Switzerland

PASSPORT APPLICATION
For Official Use Only
New Passport No. __________ O.R. No. ________ Service No. ________
Date: ____________________
PLEASE FILL IN ALL BLANKS AND TYPE OR PRINT LEGIBLY.

SURNAME :_____________________________________
GIVEN NAME :_____________________________________
MIDDLE NAME/MAIDEN NAME :_____________________________________
DATE OF BIRTH :___________________________________________________
PLACE OF BIRTH :___________________________________________________
SEX : Male Female
CIVIL STATUS : Single Married Widowed/er Separated Divorced
Name of spouse, if married :______________________ Citizenship: __________________
NAME OF FATHER :______________________ Citizenship: __________________
NAME OF MOTHER :______________________ Citizenship: __________________
ADDRESS IN PHILIPPINES :___________________________________________________
Telephone Number :___________________________________________________
FOREIGN/MAILING ADDRESS :___________________________________________________
Telephone Number :___________________________________________________
IMMIGRATION STATUS : Contract Worker Seaman Others
OCCUPATION : __________________________________________________
OFFICE OF EMPLOYMENT :___________________________________________________
Address/Telephone Number :___________________________________________________
CHECK IF YOU ARE : Legitimate Illegitimate
CITIZENSHIP ACQUIRED BY : Birth Naturalization Election Marriage
HAVE YOU EVER BEEN ISSUED A PHILIPPINE PASSPORT? Yes No
LATEST PASSPORT NUMBER :___________________________________________________
Place of Issue:______________________________________ Date Issued: ______________
HAVE YOU ACQUIRED FOREIGN CITIZENSHIP? Yes No
ARE YOU A GOVERNMENT EMPLOYEE? Yes No
PERSONS TO BE NOTIFIED IN CASE OF ACCIDENT OR DEATH:
(Philippines) Name:_____________________________________________________________
Address:______________________________________ Telephone:________________
(Abroad) Name:_____________________________________________________________
Address:______________________________________ Telephone:________________

I solemnly swear that the above attached photograph is mine, that the statements made
on this Application Form are true and the attached supporting documents are authentic.

________________________ _______________________
Signature of Applicant Signing Officer

Left Right Received by:

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