DFA-OCA-PDO-04
REV.: 00 / DEC 2016
Passport Division
Director’s Office
REQUEST FOR EXTENSION OF VALIDITY OF PASSPORT
I, __________________________________, resident of _______________________________,
(Name) (City/Municipality & Province)
request for the extension of my current valid Philippine e-passport no. _________________,
issued on __________________, at ______________ and expiring on ___________________.
Date of arrival in PH:
Reason for travel to PH:
Date of departure from PH:
Reason for travel out of PH:
I understand that I may encounter difficulties in the port of entry of the country/ies I will be
visiting and that the extension of validity of my passport is no guarantee of admission to
the country/ies of destination. I will not hold the Department of Foreign Affairs liable.
I will submit my passport with extended validity to Post/RCO/SO for cancellation upon the
release of the new passport that I have applied.
[ ] I was duly advised to renew my passport at the nearest consular office as soon as
possible.
[ ] I was duly advised that my passport will be sent to my Post of choice: _____________ .
________________________________
Signature above printed name
Date: __________________
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