Applicants Signed Photograph (passport size) taken within the last 6 months.

APPLICATION FOR NON-IMMIGRANT VISA

FA Form No. 2 (revised 2000) Embassy of the Philippines, New Delhi Visa No. ___________ Sticker No______________

Please affix signature on the front side of official use only: For picture.

Do not attach Service No. _________ OR # ______________ Amount Paid______________ scanned pictures. Surname Given Name Middle Name [ [ ] Male ]Female Date of Birth _____/_______/______ Date / Month/ Year Age: ______

Nationality

Civil Status: [ Name of Spouse

] Single [

] Married

] Widowed [

] Separated

] Divorced

Names of Children Name of Father Name of Mother If less than 15 years old, name and relationship of traveling companion: Home Address of Applicant

Since

Telephone No:

Mobile No:

Name of Company and Company Address of Applicant

Since

Telephone No:

Designation of Applicant

Passport Number

Date of Issue (day, month, year)

Valid until

Place of Issue

Purpose of Visit to the Philippines

Duration of Stay

Number of Entries Applied for Date of Arrival in the Philippines (day, month, year)

Single entry[

6 months Multiple entry [

Flight Number (arrival in Philippines)

1 yr Multiple entry* [ ] *for business visa only Philippine Port of Entry

For temporary visitors visa and transit visa holders: Please present to the Philippine immigration officer your return or onward journey plane ticket.

Name of Reference in Philippines

Address in Philippines

Telephone Number

For more information on Philippine visa matters, please visit www.newdelhipe.com.

September 20, 2009

Have you been convicted of any crime? [ ] No [ ] Yes. Please provide details. ______________________________________________ Have you been issued a Philippine visa before? [ Date of Issue _________________ Do you have any communicable disease? [ Do you have a history of mental illness? [ ] No ] No ] No [ ] Yes. Latest visa number issued: ________________

[ [

] Yes. Please provide details. ________________________ ] Yes. Please provide details. _________________________

Were you ever refused any kind of Philippine visa, denied admission into or deported from the Philippines and removed at government expense from the Philippines and other countries? [ ] No [ ] Yes. Please provide circumstance __________________________________________

For those applying for a Philippine visa through a travel agent or representative. Name of Travel Agent/ Representative: ________________________________________________ Contact details _______________________________________________________________________

I agree that any false or misleading statement and submission of fraudulent documents will result in the refusal of a visa. I agree to submit documents in addition to those submitted as indicated in the List of Submission of Required Documents, if required.

I agree that submission of compete documentary requirements is not a guarantee that a visa will be issued.

I agree that since my application will go through the visa processing procedure, the processing visa fee that I will pay will not be refunded even if no visa is issued to me.

I agree that the possession of a visa does not automatically entitle the bearer to enter the Philippines upon arrival at any port or entry if he or she is found inadmissible.

I agree that I may enter the Philippines at the port of entry designated by the Philippine Immigration Authorities and under the conditions imposed by those authorities.

I have read and understood all the questions in this application form and the answers I have furnished on this form are true and correct to the best of my knowledge and belief.

_________________________ DATE

______________________________ SIGNATURE OF APPLICANT

FOR OFFICIAL USE ONLY

Dear Applicant: You are requested to submit additional requirements to establish you as a qualified applicant for the visa category you have applied for within 5 working days upon receipt of notice from the Philippine Embassy, New Delhi. Your credentials have not established you as a qualified applicant for the visa category you have applied for.

For more information on Philippine visa matters, please visit www.newdelhipe.com.

September 20, 2009