REVISED: DOPS/MEMO/073-12/UCM/rob
Republic of the Philippines
DEPARTMENT OF FOREIGN AFFAIRS
Diplomatic and Official Passports Section
Tel. No. 651 9419; Fax No. 836 7765; Email: oca_dops@yahoo.com.ph
PASSPORT APPLICATION FORM
THIS APPLICATION FORM IS NOT FOR SALE. PLEASE DO NOT LEAVE ANY SPACES BLANK, INDICATE N/A IF NOT APPLICABLE. PROVIDING FALSE
STATEMENTS IN THE PASSPORT APPLICATION IS PUNISHABLE BY LAW (R.A. 8239)
___________________________________
________________________________
LAST NAME
FIRST NAME
MIDDLE NAME
PLACE OF BIRTH
_______________________________________
____________________________________
GENDER:
Day
DATE OF BIRTH
Month (in words)
Civil Status:
Single
MALE
FEMALE
Year
Married
Widow/er
Complete Address:
Legally Separated
Annulled
Tel. No./Mobile No.:______________________________________
Email Address: _________________________________________
Citizenship: ____________________________________________
Citizenship: ____________________________________________
Citizenship: ____________________________________________
Name of Spouse:
Name of Father:
Maiden/Single Name of Mother:
Citizenship Acquired By:
Birth
Election
Marriage
Naturalization
Are you a holder of a foreign passport?
Yes
No
If Yes, from what country? _____________________________
R.A. 9225
Others:
Have you ever been issued a Philippine Passport?
Yes
No
If Yes, latest Passport Number?____________________________________
Date of Issue: ___________________Place of Issue:___________________
PURPOSE OF TRAVEL
DATE OF TRAVEL
:___________________________________________________________________________________
DESTINATION
:____________________________________
Transit via: _________________________________
(FOR VISA REQUIREMENTS, PLEASE CONSULT/COMMUNICATE WITH THE CONCERNED EMBASSY/CONSULATE)
Request for Note Verbale
Yes
No
OFFICE OF EMPLOYMENT :___________________________________________________________________________________
DESIGNATION
:___________________________________________________________________________________
(As Stated in the Service Record)
I SOLEMNLY SWEAR UNDER PENALTY OF LAW
attached documents are authentic.
that the statements made on this application form are true and the
___________________________________
Signature of Applicant
Received Cancelled Passport:
Received New Passport:
___________________________________________
Signature over Printed Name/Date
________________________________________________
Signature over Printed Name/Date
FOR USE OF THE DEPARTMENT OF FOREIGN AFFAIRS ONLY.
REMARKS:
1.
2.
3.
_________________________________
Conform, Signature over Printed Name
Passport Sticker:
DIPLOMATIC
Date
Processor
Encoder
Approving Officer
OFFICIAL
:____________________ Time:_________
:__________________________________
:__________________________________
:
WILFREDO C. SANTOS
Assistant Secretary
Office of Consular Affairs
REQUIREMENTS
FOR NEW APPLICANT
Personal Appearance
Duly accomplished application form
Birth Certificate (BC) in Security Paper
(SECPA) issued by the National Statistics Office
(NSO) or Certified True Copy (CTC) of BC
issued by the Local Civil Registrar (LCR) duly
authenticated by NSO or Present and submit a
photocopy of regular passport.
In Case of No Birth Record:
If born in or after 1950 :
Apply for the delayed registration of birth
at the local civil registrar
Submit Authenticated Birth Certificate
(NSO) and supporting document
indicating date, of birth and citizenship.
Any public document indicating date ,
place of birth and citizenship.
For Married Women, Submit Marriage Contract
(MC) in Security Paper (SECPA) issued by
NSO or CTC issued by the Local Civil Registrar
duly
authenticated by NSO.
FOR PASSPORT RENEWAL
Personal Appearance
Present and submit photocopy of the data page
of old diplomatic/official passport
FOR LOST PASSPORT
Submit Affidavit of Loss.
If still valid, submit Police Report and Affidavit of
Loss. There will be a fifteen (15)-day clearing
period prior to the processing of application for
a replacement of lost valid passport.
Submit same documents required for the new
applicants.
If born before 1950 :
Certificate of Non-availability of Birth
Record from the NSO.
Notarized Joint Birth Affidavit
Any public document indicating date,
place of birth and citizenship.
ADDITIONAL REQUIREMENTS
1. Original and/or Certified True Copy of Signed Travel Authority;
2. Indorsement Letter addressed to the DFA (Indorsement Letter is no longer required if Travel Authority
is already addressed to the DFA);
3. Certified True Copy of the Letter of Invitation from Sponsor;
4. Training Contract, (Original Copy) in case the travel is for training, fellowship, scholarship and/or
study grant;
5. NEDA Indorsement, (Original Copy) in case the travel is for training, fellowship, scholarship or study
grant for the period of two (2) months or more;
6. Original Latest Service Record/Appointment (with full middle name);
7. Original Certificate of No Pending Administrative Case/Record (CNPAC);
8. Certified True Copy of Presidential Full Powers or Appointment Paper (for Presidential Appointees);
9. Certified True Copy of Approved Civil Service Appointment (for co-terminus Appointees);
10. Certified True Copy of Oath of Office (for Elected Officials); and,
11. Photocopy of Applicants Office I.D. and Authorized Representatives I.D.
12. For transit visa, submit confirmed flight itinerary.
Per Department Order No. 15-10 dated 21 October 2010, the applicable fees for the diplomatic and
official e-Passports are as follows:
Regular processing/issuance of Diplomatic/Official e-Passport [10 working days]
Expedite/rush processing [5 working days]
Replacement of lost e-Passport
Extension of Passport validity
P 950.00
P 1,200.00
P 1,300.00
P 200.00
REMINDER
The applicant is responsible in securing a visa to his country of destination and/or transit. It
is advised that the applicant consult the concerned Embassy or Consulate of the country of
transit/destination for the latest visa and related travel advisories before the date of
departure.
