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NBI Online Application

This document is an NBI clearance application form for Christopher Binas Biasbas. It provides his personal details like name, date of birth, address, parents' names, as well as his passport and contact information. The purpose of the application is for local employment. At the bottom, Biasbas signs to certify that the information provided is true and understands falsification is punishable by law.

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Chris Biasbas
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1K views

NBI Online Application

This document is an NBI clearance application form for Christopher Binas Biasbas. It provides his personal details like name, date of birth, address, parents' names, as well as his passport and contact information. The purpose of the application is for local employment. At the bottom, Biasbas signs to certify that the information provided is true and understands falsification is punishable by law.

Uploaded by

Chris Biasbas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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7/31/2014

NBI Online Application

PRINT APPLICATION

B2123040343

REPUBLIC OF THE PHILIPPINES


DEPARTMENT OF JUSTICE
NATIONAL BUREAU OF INVESTIGATION

NBI CLEARANCE APPLICATION FORM

APPLICANT TY PE
RENEWAL

1. ID PRESENTED
PASSPORT EB1907710

2. PURPOSE TY PE
LOCAL

3. PURPOSE APPLICATION
LOCAL EMPLOYMENT

BASIC INFORMATION
5. FAMILY NAME
BIASBAS

6. HUSBAND FAMILY NAME (FOR MARRIED WOMAN ONLY )

7. GIVEN NAME
CHRISTOPHER

8. MIDDLE NAME
BINAS

9. NICKNAME
CHRIS

10. OTHER NAME/ALSO KNOW AS

11. DATE OF BIRTH


07/15/1984

12. BIRTH PLACE


LUCENA, QUEZON

13. CITIZENSHIP
FILIPINO

14. GENDER
MALE

16. SPOUSE
MARQUILIN P. BIASBAS

17. BIRTH PLACE


MALANDAY, MARIKINA

15. CIVIL STATUS


MARRIED

18. PRESENT ADDRESS


L-223 HAMPTON GARDENS, 100 C. RAYMUNDO AVE., MAYBUNGA PASIG CITY
19. CONTACT NUMBER
09285202373

20. EMAIL ADDRESS


[email protected]

21. IDENTIFY ING MARKS

24. COMPLEXION
BROWN

25. RELIGION
ROMAN CATHOLIC

ADDITIONAL INFORMATION
22. HEIGHT
172
26. EDUCATIONAL ATTAINMENT
COLLEGE GRADUATE

23. WEIGHT
65

27. OCCUPATION
IT SPECIALIST

PARENTS INFORMATION
28. NAME OF FATHER
JOSE M. BIASBAS

29. FATHER BIRTH PLACE


SAMPALOC, MANILA

30. NAME OF MOTHER


AMELIA R. BINAS

31. MOTHER BIRTH PLACE


SAMPALOC, MANILA

FOR ALIEN APPLICANT'S ONLY


32. FOREIGN NAME

http://nbi.njis-ph.com/print/B2123040343

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7/31/2014

NBI Online Application

33. ADDRESS ABROAD


34. PASSPORT NUMBER

35. DATE ISSUED


-

36. PLACE ISSUED


-

37. ACR NUMBER


-

38. DATE ISSUED


-

39. PLACE ISSUED

I certify that I have read and understood all the questions set forth in this application and answer I have furnished on this form are true and correct to the best acknowledge and belief. I understand that any false or
misleading statement is FALSIFICAT ION PUNISHABLE UNDER ART ICLE 171 & 172 OR REVISED PENAL CODE

________________________________

________________________________

36. DATE

37. SIGNATURE

2014 All Rights Reserved

http://nbi.njis-ph.com/print/B2123040343

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