Aqiqah

DFA-OCA-DOPS-02
Republic of the Philippines REV. 01 / 24 OCT 2018

DEPARTMENT OF FOREIGN AFFAIRS
Diplomatic and Official Passports Section
Tel. No. 651-9419; Fax No. 836-7765; e-mail oca.dops@dfa.gov.ph
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 STATEMENT IN THE
PASSPORT APPLICATION FORM IS PUNISHABLE BY LAW (R.A. 8239)
LAST NAME FIRST NAME (Jr., Sr., II, III)

_____________________________________ _____________________________________
MIDDLE NAME PLACE OF BIRTH
_____________________________________ _____________________________________
DATE OF BIRTH (DD/ MONTH IN WORDS /YYYY) GENDER
_________ / ________________ / _________ MALE FEMALE
Civil Status: Single Married Widow/er Legally Separated Annulled

Complete Address: _____________________________________ Tel. No. / Mobile No. ______________________________
_____________________________________________________ e-mail address: ___________________________________
Spouse’s Name: _______________________________________ Citizenship: ______________________________________
Father’s Name: ________________________________________ Citizenship: ______________________________________
Mother’s Maiden Name: _________________________________ 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 Diplomatic / Official passport: YES NO
If YES, indicate latest passport no. : ___________________________________
If YES, from what country? ______________________ Issuance Date: __________________ Place Issued: ______________________
PURPOSE OF TRAVEL: _______________________________________________________________________________________________

DATE OF TRAVEL: ___________________________________________________________________________________________________
DESTINATION: __________________________________________ TRANSIT / LAY-OVER: ________________________________________
REQUEST FOR NOTEVERBALE? YES NO

(FOR VISA REQUIREMENTS PLEASE COORDINATE WITH THE CONCERNED EMBASSY / CONSULATE)
I SOLEMNLY SWEAR UNDER THE PENALTY OF LAW that the statements made on this application form are true and the attached
documents are authentic. Likewise, I hereby declare that I have been made aware of the application requirements and swear to submit all lacking
requirements on the date of release. I also acknowledge that the Department has the right to hold the release of my passport until I have satisfied
all requirements.
___________________________
Signature of Applicant
DO NOT WRITE BELOW THIS PART. FOR THE DEPARTMENT OF FOREIGN AFFAIRS’ USE ONLY.
Passport Type: Diplomatic Official Validity: ______________ Passport Slip No: ________________
Designation: __________________________________________________________________________________________
__________________________________________________________________________________________
Received cancelled passport: Received new passport:

________________________________________ ________________________________________
Signature over printed name Signature over printed name
REMARKS:
Date : _____________________________
Processor : _____________________________
Encoder : _____________________________
Approving Officer :
Released by: ___________________________________

DOCUMENTARY REQUIREMENTS
FOR NEW APPLICANT  Notarized Joint Birth Affidavit of Two Disinterested
 Personal appearance Persons;
 Duly accomplished application form  Any public document indicating date, place of birth
 Original PSA Birth Certificate (if details in birth certificate and citizenship.
are unreadable, provide local copy of birth certificate of the  Government Issued ID
same format. If still unreadable applicant must provide a
transcribed copy of the birth certificate from the Local Civil FOR PASSPORT RENEWAL
Registrar where the applicant was born / registered) or  Personal appearance
present and submit a photocopy of regular e-passport.  Present and submit photocopy of the data page of old
 For married women, submit also original PSA Marriage diplomatic / official e-passport; For those with passports
Contract (if details in marriage contract are unreadable, issued before October 2010, submit original readable PSA
provide local copy of the marriage contract of the same Birth Certificate (if details in birth certificate are
format. If still unreadable, applicant must provide a unreadable, provide local copy of birth certificate of the
transcribed copy of the marriage contract from the Local same format. If still unreadable applicant must provide a
Civil Registrar where the marriage was registered). transcribed copy of the birth certificate from the Local Civil
Registrar where the applicant was born / registered) or
In Case of No Birth Record present and submit a photocopy of regular e-passport.
 For married women, submit also original PSA Marriage
If born in or after 1950 Contract (if details in marriage contract are unreadable,
 Certificate of Non-availability of Birth Record from the provide local copy of the marriage contract of the same
PSA; format. If still unreadable, applicant must provide a
 Apply for the delayed registration of birth at the local transcribed copy of the marriage contract from the Local
civil registrar; Civil Registrar where the marriage was registered).
 Submit original PSA Birth Certificate and supporting
documents indicating date, of birth and citizenship; FOR LOST PASSPORT
 Any public document indicating date , place of birth  Submit Affidavit of Loss.
and citizenship  If lost passport is still valid, submit Police Report and
 Government Issued ID Affidavit of Loss. There will be a 15-day clearing period
prior to the processing of application for a replacement of
If born before 1950 lost valid e-passport.
 Certificate of Non-availability of Birth Record from the  Submit same documents required for new passport
PSA; applicants.
ADDITION AL REQUIREMENTS
1. Original and/or Certified True Copy of Signed Travel Authority;
2. Endorsement Letter addressed to DFA (Endorsement Letter is no longer required if Travel Authority is already addressed
to DFA);
3. Letter of Invitation from sponsor / organizer;
4. Original Training Contract if duration of training, fellowship, scholarship and/or study grant is one (1) month or longer;
5. Original latest Service Record;
6. Original Certificate of No Pending Administrative Case;
7. Certified True Copy of Presidential Full Powers or Appointment Paper (for presidential appointees);
8. Certified True Copy of Approved Civil Service Appointment (for co-terminus appointees);
9. Certified True Copy of Oath of Office (for Elected Officials);
10. Photocopy of Applicant’s Office I.D. and Authorized Representative’s I.D.; and,
11. For transit to countries where visa is required, submit confirmed flight itinerary.
*As required by the US Embassy – Manila, applicants traveling to the United States of America are requested to provide
following documents to pertaining to 1) where official travel will take place, 2) brief description of their duties and
responsibilities, and 3) company / organization sponsoring the travel.
Per Department Order No. 15-10 dated 21 October 2010, the applicable fees for the diplomatic and official e-Passports are
as follows:
Regular processing of Diplomatic/Official e-Passport (7 working days) - P 950.00
Expedite processing of Diplomatic/Official e-Passport (5 working days) - P 1, 200.00
Penalty for lost Diplomatic/Official Passport - P 350.00
REMINDER
The applicant is responsible in securing a visa to his/her country of destination and/or transit. It is advised that the
applicant consult the concerned Embassy or Consulate of the country of transit/destination for the latest visa and
related travel advisories before the date of departure.

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DFA-OCA-DOPS-02

Republic of the Philippines REV. 01 / 24 OCT 2018

LAST NAME FIRST NAME (Jr., Sr., II, III)

Civil Status: Single Married Widow/er Legally Separated Annulled

PURPOSE OF TRAVEL: _______________________________________________________________________________________________

REQUEST FOR NOTEVERBALE? YES NO

Received cancelled passport: Received new passport:

Released by: ___________________________________

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