Form No. 2 ENGLISH
RENEWAL REGULAR PASSPORT APPLICATION FORM (Adult)
THIS FORM IS NOT FOR SALE
with no answers. Tick () boxes as appropriate.
CURRENT PASSPORT DETAILS
PASSPORT NUMBER:
ISSUING AUTHORITY:
DATE OF ISSUE:
DATE OF EXPIRY:
PASSPORT APPLICANT’S INFORMATION
1. LAST NAME
2. FIRST NAME
3. MIDDLE NAME or MAIDEN LAST NAME
4. SEX
MALE
FEMALE
5. DATE OF BIRTH (ex. 01 Jan 2017)
D
D
M
M
M
Y
Y
6. PLACE OF BIRTH
(For born in PHL: Municipality/City & Province
For born outside PHL: Country)
_______________________________
7. CIVIL STATUS
SINGLE
MARRIED
WIDOW/ER
NULLIFIED /
ANNULLED
DIVORCED (with
recognition by
PHL Court)
8a. HOW DID YOU ACQUIRE PHL
CITIZENSHIP?
BY BIRTH
BY NATURALIZATION
BY RE-ACQUISITION (RA No. 9225)
BY ELECTION
BY LEGISLATION
8b. DID YOU EVER LOSE YOUR PHL
CITIZENSHIP? YES NO
8c. ARE YOU CURRENTLY A CITIZEN OF
ANOTHER COUNTRY?
YES NO
8d. IF YES, FROM WHAT COUNTRY?
_____________________________
8e. HAVE YOU SERVED IN ANY FOREIGN
MILITARY?
YES NO
IF Yes, what country?
_______________________________
9b. SPOUSE’S CITIZENSHIP
APPLICANT’S CONTACT INFORMATION
10a. PRESENT ADDRESS:
10b. PHILIPPINE ADDRESS:
11. HOW DO YOU WISH TO RECEIVE YOUR PASSPORT? PICK-UP BY MAIL (Pls. Provide Xpress Post Env.)
12. TELEPHONE/MOBILE NUMBER:
13. e-MAIL ADDRESS:
OFFICIAL RECEIPT/PAYMENT SLIP NO.:
DATE OF TRANSACTION:
DEPARTMENT OF FOREIGN AFFAIRS
Office of Consular Affairs Last Revision: 14 February 2018
INSTRUCTIONS: Please PRINT entries legibly using black or blue ink
only. Supply the necessary information and indicate “N/A” for entries
Site: OTTAWA PE
Date/Time: Day, DD Mon YYYY/0000HR
____________________________________
Booking Reference No._________________
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Form No. 2 ENGLISH
PARENTAL INFORMATION
14. FATHER’S DETAILS
15. MOTHER’S DETAILS (MAIDEN /SINGLE NAME)
Last Name:
Last Name:
First Name:
First Name:
Middle Name:
Middle Name:
Citizenship (at time of applicant’s birth)
Citizenship (at time of applicant’s birth)
16a. PERSON TO CONTACT IN CASE OF EMERGENCY:
16b. TEL/MOBILE NO. OF PERSON TO NOTIFY:
STATUS OF CURRENT PASSPORT
Please choose as applicable:
Passport Intact
Damaged Passport
Affidavit of Explanation
Lost Valid Passport
Affidavit of Loss
Police Report in English
Lost Expired Passport
Affidavit of Explanation
WAIVER OF LIABILITY
Mail Tracking No: ______________________________________________
DECLARATION OF APPLICANT
I HEREBY DECLARE AND AFFIRM 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 consent to the verification by the Philippine
Government of the information I provided to establish my personal particulars, and further consent to issue its use for any
lawful purpose. 5) I am aware that the information provided in this application will be treated in accordance with relevant
privacy regulations. 6) I am aware that under the law, I am allowed to hold only one valid regular Philippine passport at a
given time; 7) I am aware that making false statements in this passport application and furnishing falsified or forged
documents are punishable by fine or imprisonment, and grounds for suspension or denial of application. 8) I understand
and accept the release of the passport could be subject to delay due to unforeseen events beyond the control of the
Department of Foreign Affairs.
________________________________________ ________________________________
17. SIGNATURE OVER PRINTED NAME 18. DATE (ex. 01 Jan 2017)
PROCESSOR’S
SIGNATURE:
WATCHLIST
VERIFICATION:
SIGNATURE OF APPLICANT/REPRESENTATIVE TO RECEIVE:
BORROWED
PASSPORT
CANCELLED
PASSPORT
NEW PASSPORT
REMARKS:
SIGNATURE
ENCODER:
SIGNING OFFICER:
END
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I waive any & all claims that may now and in the future have against, & the release & hold free from any
responsibility or liability & agree not to sue the Philippine Embassy in Ottawa or any of its officers & staff or
its agents/representatives for any personal injury, expense, loss or damage that I may suffer or sustain as a
result or by reason of the mailing of my passport/documents using the services of Canada Post or courier.