You are on page 1of 1

12/14/2015

NBICLEARANCE
REPUBLICOFTHEPHILIPPINES
DEPARTMENTOFJUSTICE
NATIONALBUREAUOFINVESTIGATION

AABY3RC5
()
REFERENCENUMBER

NBICLEARANCEAPPLICATION
FORM

MondayDec14,2015AM
ValidUntilDec29,2015
APPLICANTTYPE
NEW

1.IDPRESENTED
Philhealth

2.PURPOSETYPE
LOCAL

3.PURPOSEAPPLICATION
LOCALEMPLOYMENT

BASICINFORMATION
5.FAMILYNAME
GUICO

6.HUSBANDFAMILYNAME(FORMARRIEDWOMANONLY)

7.GIVENNAME
ANGELO

8.MIDDLENAME
SEVILLA

9.NICKNAME

10.OTHERNAME/ALSOKNOWAS

11.DATEOFBIRTH
02/20/1986

12.BIRTHPLACE
MANILA

13.CITIZENSHIP
FILIPINO

14.GENDER
MALE

16.SPOUSE

17.BIRTHPLACE

15.CIVILSTATUS
SINGLE

18.PRESENTADDRESS
437KUNDIMANST.BALICBALICSAMPALOCMANLIA
19.CONTACTNUMBER
09214178988

20.EMAILADDRESS
angeloguico0220@gmail.com

21.IDENTIFYINGMARKS

24.COMPLEXION
FAIR

25.RELIGION
ROMANCATHOLIC

ADDITIONALINFORMATION
22.HEIGHT
172
26.EDUCATIONALATTAINMENT
COLLEGEGRADUATE

23.WEIGHT
78

27.OCCUPATION
BANKEMPLOYEE

PARENTSINFORMATION
28.NAMEOFFATHER
ROSAUROGUICO

29.FATHERBIRTHPLACE
MANILA

30.NAMEOFMOTHER
WILHELMINAGUICO

31.MOTHERBIRTHPLACE
MANILA

IcertifythatIhavereadandunderstoodallthequestionssetforthinthisapplicationandanswerIhavefurnishedonthisformaretrueandcorrecttothebestacknowledgeandbelief.Iunderstandthat
anyfalseormisleadingstatementisFALSIFICATIONPUNISHABLEUNDERARTICLE171&172ORREVISEDPENALCODE

________________________________

________________________________

36.DATE

37.SIGNATURE

2015AllRightsReserved

https://www.nbiclearance.com/print

1/1

You might also like