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Travel Pass Application Form

This document is a travel pass application form for aliens leaving and returning to the Philippines. It requests information such as the applicant's personal details, travel itinerary, and visa/permit details like ACR and ICR numbers. The applicant must sign and date the form, swearing that all information provided is true and correct and there are no pending legal matters requiring their presence.

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Jia Yap
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250 views

Travel Pass Application Form

This document is a travel pass application form for aliens leaving and returning to the Philippines. It requests information such as the applicant's personal details, travel itinerary, and visa/permit details like ACR and ICR numbers. The applicant must sign and date the form, swearing that all information provided is true and correct and there are no pending legal matters requiring their presence.

Uploaded by

Jia Yap
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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BI FORM 2021-03-001 Rev 0 This document may be reproduced and is NOT FOR SALE

TRAVEL PASS APPLICATION FORM


I. APPLICATION INFORMATION ATTACHMENT:

SPECIAL VISA FOR EMPLOYMENT GENERATION (SVEG) 1. Photocopy of Passport Biopage;

RA8756 IN RELATION TO EO226 2. Airline Ticket;

3. Visa Implementation Page.


PD1034

RA7837 (VETERANS)

(A separate form must be submitted for each application.)

The Honorable
BUREAU OF IMMIGRATION
Manila

Sir:

The undersigned aliens hereby makes this sworn application for Travel Pass Certificate in compliance to Inter-Agency Task Force for the Management of
Emerging Infectious Diseases (IATF-MEID) Resolution No. 99-A Series of 2021 issued on 11 February 2021, and submit the following information in support,
thereof.
II. APPLICANT’S PERSONAL INFORMATION
Last Name

First/Given Name

Middle Name

Residential Address in the Philippines


House/Unit No., Street, Subdivision

Barangay, Municipality/City

Province, Zip Code

Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990] Gender Citizenship/Nationality


M F
Marital Status Country of Birth
Single Annulled Widowed

Married Separated Divorced


If married, widowed, or divorced, give the name and address of present or former spouse:
Name of Spouse [Last Name, First/Given Name, Middle Name]

Address of Spouse

III. APPLICANT’S TRAVEL INFORMATION


Applicant’s Status of Latest Admission in the Philippines Date of Latest Admission in the Philippines [DD-MMM-YYYY e.g. 01 JAN 1990]

Date of Intended Departure [DD-MMM-YYYY e.g. 01 JAN 1990] Destination

Flight Number: Passport No.

Reason for Leaving:

Date of Intended Return [DD-MMM-YYYY e.g. 01 JAN 1990] Estimated Length of Stay Abroad [e.g. 20 days, 2 months, etc.]

IV. ACR I-CARD INFORMATION, IF APPLICABLE


Alien Certificate of Registration (ACR) No.

Place of Issuance Date of Issuance [DD-MMM-YYYY e.g. 01 JAN 1990]

Immigration Certificate of Registration (ICR) No.

Place of Issuance Date of Issuance [DD-MMM-YYYY e.g. 01 JAN 1990]

I hereby swear/affirm that all information provided is true and correct to the best of my knowledge and belief; that I voluntarily submitted
authenticated/ original documents to verify my application, and that there exists no pending criminal civil or administrative action which requires my
presence.

Date Applicant’s Signature over Printed Name

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