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    Emigration Clearance Certificate (Ecc) Application Form

    Uploaded by

    Jec Gagua
    This document is an application form for an Emigration Clearance Certificate (ECC) from the Bureau of Immigration in the Philippines. The form collects information such as name, date of birth, citizenship, passport details, and contact information. It explains the different types of ECCs available, including for Philippine citizens, student visa holders, and tourist visa holders staying over six months. Applicants must provide a recent photograph and swear that the information is true before signing and providing fingerprints. The bottom portion is a claim stub to be filled out by immigration officials after filing to provide tracking details.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Emigration Clearance Certificate (Ecc) Application Form

    Uploaded by

    Jec Gagua
    1K views1 page
    This document is an application form for an Emigration Clearance Certificate (ECC) from the Bureau of Immigration in the Philippines. The form collects information such as name, date of birth, citizenship, passport details, and contact information. It explains the different types of ECCs available, including for Philippine citizens, student visa holders, and tourist visa holders staying over six months. Applicants must provide a recent photograph and swear that the information is true before signing and providing fingerprints. The bottom portion is a claim stub to be filled out by immigration officials after filing to provide tracking details.

    Original Title

    ECC App Form

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    This document is an application form for an Emigration Clearance Certificate (ECC) from the Bureau of Immigration in the Philippines. The form collects information such as name, date of birth, citizenship, passport details, and contact information. It explains the different types of ECCs available, including for Philippine citizens, student visa holders, and tourist visa holders staying over six months. Applicants must provide a recent photograph and swear that the information is true before signing and providing fingerprints. The bottom portion is a claim stub to be filled out by immigration officials after filing to provide tracking details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views1 page

    Emigration Clearance Certificate (Ecc) Application Form

    Uploaded by

    Jec Gagua
    This document is an application form for an Emigration Clearance Certificate (ECC) from the Bureau of Immigration in the Philippines. The form collects information such as name, date of birth, citizenship, passport details, and contact information. It explains the different types of ECCs available, including for Philippine citizens, student visa holders, and tourist visa holders staying over six months. Applicants must provide a recent photograph and swear that the information is true before signing and providing fingerprints. The bottom portion is a claim stub to be filled out by immigration officials after filing to provide tracking details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    BI FORM 2014-08-004 Rev 0 This document may be reproduced and is NOT FOR SALE

    EMIGRATION CLEARANCE CERTIFICATE (ECC) APPLICATION FORM


    I. APPLICATION INFORMATION
    Attach your 2x2 colored photograph II.ECC-A
    with white background
    Philippine Born Philippine Born-US Passport Holder Student Visa
    using permanent glue in the
    photograph box. Lost ACR I-Card Tourist (with More than Six Months of Downgraded Visa
    Stay in the Philippines)
    The photograph must be taken
    within the last three (3) months ECC-B
    from the date of application.
    Re-Entry Permit (RP) Special Return Certificate (SRC)
    A scanned photograph is not
    allowed. A photograph of the Certificate Of Exemption (CE)
    applicant wearing eyewear (i.e.
    sunglasses, colored contact lenses, II. METHOD OF APPLICATION
    etc.) or headwear is not acceptable.
    Personal Authorized Representative

    III. APPLICANT’S PERSONAL INFORMATION


    Last Name

    First/Given Name

    Middle Name

    Other Name(s)/ Alias(es)


    1

    2
    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


    Residential Address in the Philippines Contact Number(s) in the Philippines
    House/Unit No., Street, Subdivision Landline

    Barangay, Municipality/City Mobile

    Province, Zip Code Email Address

    Name of Spouse [Last Name, First/Given Name, Middle Name]

    IV. APPLICANT’S TRAVEL INFORMATION


    Passport Number Place of Issuance

    Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990] Date of Latest Arrival [DD-MMM-YYYY e.g. 01 JAN 1990]

    V. Alien Certificate of Registration Identity Card (ACR I-Card)


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

    Place of Issuance Expiry Date/Valid Until [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 DO NOT FILL OUT THIS PORTION
    documents to verify my application, and that there exists
    no pending criminal civil or administrative action which
    requires my presence.
    Received by: __________________________________

    ___________ _________________________________ Recommended by: ______________________________


    Date Applicant’s Signature over Printed Name
    Left Right
    Reviewed by: __________________________________
    Thumbprint Thumbprint
    Approved by: __________________________________
    Verified by: ________________________________
    Fingerprint Examiner
    (Signature over Printed Name)

    [To be filled out by Authorized BI Personnel Only]

    ECC-A/CE/ECC-B/SRC/RP CLAIM STUB


    Name of SUBJECT [Last Name, First/Given Name, Middle Name]

    _____________________
    Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990] Date & Time FILED

    Citizenship/Nationality
    _____________________
     ECC Reference Number shall be sent through e-mail, if e-mail address is provided. Date & Time RELEASED
     Always present this claim stub upon claiming your certificate.
     Unclaimed certificate shall be automatically cancelled after 30 days from the date of issuance. ___________________________
     If claimed by an authorized representative, present a Special Power of Attorney (SPA) and original BI Receiving Personnel
    valid government-issued ID.

    Page 1 of 1

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