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Courtesy Lane Passport Application Form Fillable

The document is a passport application form from the Department of Foreign Affairs of the Republic of the Philippines that collects personal information such as name, date of birth, citizenship details, contact information, and previous passport information from applicants. It requires applicants to swear that the information provided is true and correct. The form also allows optional organ donation upon death to save other people's lives.

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155 views

Courtesy Lane Passport Application Form Fillable

The document is a passport application form from the Department of Foreign Affairs of the Republic of the Philippines that collects personal information such as name, date of birth, citizenship details, contact information, and previous passport information from applicants. It requires applicants to swear that the information provided is true and correct. The form also allows optional organ donation upon death to save other people's lives.

Uploaded by

9cwkwgccdj
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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DFA-OCA-PDO-02

REV.01/APR2023
Republic of the Philippines
DEPARTMENT OF FOREIGN AFFAIRS

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 PASSPORT APPLICATIONS IS PUNISHABLE BY LAW (R.A. 8239).

____________________________________________ _________________________________________________
LAST NAME / APELYIDO FIRST NAME / PANGALAN (JR. / II / III )

____________________________________________ _________________________________________________
MIDDLE NAME / GITNANG PANGALAN PLACE OF BIRTH / POOK NG KAPANGANAKAN

___________________/_____________/___________ GENDER / KASARIAN ☐ MALE ☐ FEMALE


Month Day Year
DATE OF BIRTH / PETSA NG KAPANGANAKAN
(Ex. March 8, 2010)

Civil Status: ☐ Single ☐ Married ☐ Widow/er ☐ Legally Separated ☐ Annulled

Complete Address: _____________________________________________________ Tel. No.: _________________________


Present Occupation: ____________________________________________________ Mobile No.: _______________________
Work Address: _________________________________________________________ Tel. No.: _________________________
E-mail Address: ___________________________________________________________________________________________
Name of Wife / Husband: _________________________________________________ Citizenship: ______________________
Name of Father: ________________________________________________________ Citizenship: _______________________
Maiden / Single name of Mother: ___________________________________________ Citizenship: _______________________

Citizenship Acquired By:


☐ Birth ☐ Election ☐ Marriage ☐ Naturalization ☐ R.A. 9225 ☐ Others ____________

Are you a holder of a foreign passport? ☐ Yes ☐ No Have you ever been issued a Philippine Passport? ☐ Yes ☐ No
If Yes, from what country? ____________________________ If Yes, latest Passport Number? _______________________________
Date of issue: __________________ Place of issue: _______________
(For applicants below 18 years old ONLY)
Name of minor's travelling companion: _________________________________________________________________________
Companion's relationship: ______________________________________________ Contact Number: ______________________

I SOLEMNLY SWEAR that 1) I am a Filipino citizen. 2) The information I provided in this application are true and correct.
3) The supporting documents are authentic. 4) I am aware that under the law, I am allowed to hold only one Philippine passport at
any given time. 5) I am aware that making false statements in passport application, furnishing falsified or forged documents in
support thereof are punishable by law.
______________________________________________
Signature of Applicant or Legal Guardian (for minor applicants)

ORGAN DONATION (Optional)


In case of death, I hereby donate [ ] Any organ/tissue [ ] Specific organ ________________________ to save other people.
Please immediately notify my family at mobile/tel. no. _____________________.

FOR USE OF THE DEPARTMENT OF FOREIGN AFFAIRS ONLY. PLEASE DO NOT WRITE BELOW THIS LINE.

REMARKS:

Processor: Encoder: Signing Officer: Transmission Officer:


RECEIVED CANCELLED PASSPORT: RECEIVED NEW PASSPORT:

FOR ADMINISTRATIVE USE ONLY:

For more details, please visit https://dfa-oca.ph/

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