Application For Passport New Or Renewal

FOREIGN SERVICE OF THE PHILIPPINES PHILIPPINE CONSULATE GENERAL JEDDAH, KINGDOM OF SAUDI ARABIA Revised December 2008 (KSA)

PASSPORT APPLICATION THIS FORM IS NOT FOR SALE

PASTE 1st PHOTO HERE

Photo Size: 3.5 cm X 4.5 cm. With Royal Blue Background

FROM 1 in to 1 3/8 in

APPLICATION SHALL BE COMPLETELY ACCOMPLISHED, ANSWERS TYPED OR PRINTED LEGIBLY, THUMBMARKS PRINTED CLEARLY AND ALL REQUIREMENTS SUBMITTED, OTHERWISE APPLICATION SHALL BE RETURNED UNPROCESSED. FOR ENTRIES NOT 1. LAST NAME (surname APPLICABLE or family name) WRITE N/A. PLACE APPLICANT’S THUMBMARKS HERE LEFT THUMB RIGHT THUMB

FOR OFFICIAL USE ONLY

2. FIRST NAME (given name(s) written on birth certificate)

3. MIDDLE NAME (mother’s maiden surname, or if married, applicant’s maiden name)

4. SEX

5. DATE OF BIRTH (DD-MMM-YYYY)

 MALE

NEW PASSPORT NUMBER

 FEMALE

6. PLACE OF BIRTH (town or city, province or state, country) DATE OF ISSUE

DATE OF EXPIRY

EVIDENCE OF APPLICANT’S CITIZENSHIP

7. ADDRESS IN THE U.S. OR COUNTRY OF RESIDENCE

8. CIVIL STATUS

 Birth Certificate  Report of Birth  Passport  Naturalization Certificate  Others:

_________________________________ RECEIVER

CASHIER

LOL

PROCESSO R

SCRIPTER

ENCODER

 SINGLE  MARRIED

 WIDOWED  DIVORCED

8a. SPOUSE NAME

9a. NAME OF APPLICANT’S FATHER

9b.

10a. NAME OF APPLICANT’S MOTHER

10b.

11. APPLICATION TYPE PASSPORT

FATHER’S CITIZENSHIP AT THE TIME OF APPLICANT’S BIRTH MOTHER’S CITIZENSHIP AT THE TIME OF APPLICANT’S BIRTH

 REPLACEMENT OF LOSS

 NEW PASSPORT  RENEWAL OF PASSPORT 11b. PREVIOUS DATE OF ISSUANCE

11a. PREVIOUS PASSPORT NUMBER

11c. PREVIOUS PLACE OF ISSUANCE

SIGNING OFFICER

12. HOW PHILIPPINE CITIZENSHIP WAS ACQUIRED? MARRIAGE

FEE

O.R. NO.

 NATURALIZATION  R.A. 9225 ________________________________________________ 13. OCCUPATION

 BIRTH

 ELECTION



 OTHERS:

14. WORK ADDRESS SERVICE NO.

15. CONTACT INFORMATION (tel. no. and/or e-mail address)

16. PURPOSE OF TRAVEL

REMARKS

17. ADDRESS IN THE PHILIPPINES 18. SUPPORTING DOCUMENTS SUBMITTED:

 OLD PASSPORT  BIRTH CERTIFICATE

 MARRIAGE CERTIFICATE / CONTRACT  AFFIDAVIT OF LOSS  OTHERS:

_____________________________________________

 YES

19a. IS THIS APPLICATION TO BE FILED BY ANOTHER PERSON OR ENTITY ON YOUR BEHALF?

TIM E DUE

NEW PASSPORT RELEASED TO:

PRINTED NAME AND SIGNATURE OLD PASSPORT RECEIVED:

(FOR APPLICANTS 8 YEARS OLD AND BELOW AND 65 YEARS AND OLDER) 19b. IF YES, INDICATE NAME, ADDRESS RELATIONSHIP TO that I 19c. I SOLEMNLY SWEAR UNDER AND PENALTY OF LAW am aSIGNATURE Filipino; I OF AUTHORIZED APPLICANT OF REPRESENTATIVE am the person in the attached photograph; the thumb prints on this form are mine; the statements made on this Application Form are true and correct; and the attached supporting documents are authentic.

_________________________________ _________________________________ DATE OF APPLICATION

FROM 1 in to 1 3/8 in

DATE DUE

Attach 2nd & 3rd Photos here (DO NOT STAPLE)

Photo Size: 3.5 cm X 4.5 cm. With Royal Blue Background

 NO