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Form No. 2 – ENGLISH
RENEWAL REGULAR PASSPORT APPLICATION FORM (Adult)
DEPARTMENT OF FOREIGN AFFAIRS THIS FORM IS NOT FOR SALE
Office of Consular Affairs Last Revision: 07 October 2017
INSTRUCTIONS: Please PRINT entries legibly using black or blue
ink only. Supply the necessary information and indicate “N/A” for
entries with no answers. Tick (√) boxes as appropriate.
CAPTURE SITE PRE-PROCESSING (Do not write on this part)
APPOINTMENT VERIFICATION:
REMARKS:
PASSPORT APPLICANT’S INFORMATION
1.LAST NAME
2. FIRST NAME
3. MIDDLE NAME or MAIDEN LAST NAME
4. SEX
MALE
FEMALE
5. DATE OF BIRTH (ex. 01 Jan 2017)
D D M M M Y Y Y Y
6. PLACE OF BIRTH
(For born in the PHL: Municipality/City & Province
For born outside the PHL: Country)
7. CIVIL STATUS
SINGLE
MARRIED
WIDOW/ER
NULLIFIED /
ANNULLED
DIVORCED
8a.HOW DID YOU ACQUIRE PHL
CITIZENSHIP?
BY BIRTH
BY NATURALIZATION
BY RE-ACQUISITION (RA no. 9225)
BY ELECTION
BY LEGISLATION
8b. DID YOU EVER LOSE YOUR PH CITIZENSHIP?
YES NO
8c.ARE YOU CURRENTLY A CITIZEN OF ANOTHER
COUNTRY? YES NO
8d.IF YES, FROM WHAT COUNTRY?
8e. HAVE YOU SERVED IN ANY FOREIGN
MILITARY? YES NO
IF Yes, what country?
APPLICANT’S CONTACT INFORMATION
9a. PRESENT ADDRESS:
9b. HOME ADDRESS:
10. WHERE DO YOU WISH YOUR PASSPORT TO BE DELIVERED?
PRESENT ADDRESS HOME ADDRESS
11. TELEPHONE/MOBILE NUMBER:
12. e-MAIL ADDRESS:
Site: XXXXXXX
Date/Time: Day, DDMon YYYY/0000HR
Booking Reference no.:0123456789101112
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13. APPLICANT’S SPOUSE’S NAME:
14a. PERSON TO CONTACT IN CASE OF EMERGENCY:
14b. TEL/MOBILE NO. OF PERSON TO NOTIFY:
PARENTAL INFORMATION
CURRENT PASSPORT DETAILS
15.FATHER’S DETAILS
Last Name:
16. MOTHER’S DETAILS
Last Name:
17a.PASSPORT NUMBER
First Name:
First Name:
17b.DATE OF ISSUE
Middle Name:
Middle Name:
17c.DATE OF EXPIRY
Citizenship (at time of applicant’s birth)
Citizenship (at time of applicant’s birth)
17d.ISSUING AUTHORITY
STATUS OF CURRENT PASSPORT
19. Please choose as applicable:
Passport Intact
Damaged Passport
Affidavit of Explanation
Lost Valid Passport
Affidavit of Loss
Police Report in English
Lost Expired Passport
Affidavit of Explanation
DECLARATION OF APPLICANTS
I HEREBY DECLARE AND AFFIRM that 1) I am a Filipino citizen. 2) The information provided in this application is
true and correct. 3) The supporting documents attached are authentic. 4) I consent to the verification by the
Philippine Government of the information I provided to establish my personal particulars, and further consent to its
use for any lawful purpose. 5) I am aware that the information provided in this application will be treated in
accordance with relevant privacy regulations. 6) I am aware that under the law, I am allowed to hold only one valid
regular Philippine passport at a given time. 7) I am aware that making false statements in this passport application
and furnishing falsified or forged documents are punishable by fine or imprisonment, and grounds for suspension
or denial of application. 8) I understand and accept that the release of the passport could be subject to delay due
to unforeseen events beyond the control of the Department of Foreign Affairs.
_____________________________________ _______________________________
20. SIGNATURE OVER PRINTED NAME 21. DATE (ex. 01 Jan 2017)
DO NOT WRITE BELOW THIS LINE. FOR THE DEPARTMENT’S USE ONLY.
REMARKS:
PASSPORT WATCHLIST
VERIFICATION:
RETURNED CANCELLED
PASSPORT
SIGNATURE OF
APPLICANT:
PROCESSOR’S SIGNATURE:
ENCODER’S SIGNATURE:
OFFICIAL RECEIPT/PAYMENT SLIP NO:
DATE OF TRANSACTION:
