BI FORM CGAF-001-Rev 0 This document may be reproduced and is NOT FOR SALE

CONSOLIDATED GENERAL APPLICATION FORM

FOR IMMIGRANT VISA
I. APPLICATION INFORMATION
Present Immigration Status
Attach your 2x2 colored photograph
with white background using Nature of Application
permanent glue in the Conversion Amendment Inclusion
photograph box.
Type of Visa Application
The photograph must be taken
within the last three (3) months
Method of Application
from the date of application.
Personal Authorized Representative
A scanned photograph is not
BI Accreditation Number
allowed. A photograph of the
applicant wearing eyewear (i.e.
sunglasses, colored contact lenses, Name of Authorized Representative [Last Name, First/Given Name, Middle Name]
etc.) or headwear is not acceptable.

II. APPLICANTS TRAVEL INFORMATION

Passport Number Date of Latest Arrival [DD-MMM-YYYY e.g. 01 JAN 1990]

Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990] Flight Number

Place of Issuance Last Day of Authorized Stay [DD-MMM-YYYY e.g. 01 JAN 1990]

III. APPLICANTS PERSONAL INFORMATION

Last Name

First/Given Name

Middle Name

Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990] Gender Country of Birth

M F

Citizenship/Nationality Civil Status

Single Married Annulled

Height [cm] Weight [kg] Separated Widowed Divorced

Profession/Occupation Special Security Registration Number (SSRN)

Contact Number(s) in the Philippines Email Address

Landline

Mobile

Residential Address in the Philippines

House/Unit No., Street, Subdivision/Village Barangay, Municipality/City

Province, Zip Code Country, Zip Code

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

Name(s) of Child(ren) and Date(s) of Birth [Last Name, First/Given Name, Middle Name]
1
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]

Last Name, First/Given Name, Middle Name

2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]

Note: If the applicant has more than two (2) children, use BI Form 2014-00-005 Rev 0.
IV. PETITIONERS INFORMATION
Last Name

First/Given Name

Middle Name

Residential Address in the Philippines

House/Unit No., Street, Subdivision/Village Barangay, Municipality/City

Province, Zip Code Country, Zip Code

Contact Number(s) in the Philippines

Landline Mobile

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BI FORM CGAF-001-Rev 0 This document may be reproduced and is NOT FOR SALE
CONSOLIDATED GENERAL APPLICATION FORM
FOR IMMIGRANT VISA
V. ACR I-CARD
Alien Certificate of Registration (ACR) Number DO NOT FILL OUT THIS PORTION
Application Number
Date of Issuance [DD-MMM-YYYY e.g. 01 JAN 1990]

Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990] Received/Recommended by: ________________________________
Reviewed by: ____________________________________________
Certificate of Residence Number (CRN) Approved by: ____________________________________________

_____________________ ________________________________________ _______________________________________

Date [DD-MMM-YYYY] Petitioners Signature over Printed Name Applicants Signature over Printed Name

Evaluated and Reviewed by:

Recommended for:
_____________________________________
Supervising Visa Officer Approval
(Signature over Printed Name)
Valid from: ______________________________
Date Signed: ___________________ [DD-MMM-YYYY]
Until: ______________________________
[DD-MMM-YYYY]
Recommending Approval:
Disapproval*

* Please see attached findings.

____________________________________________
Head, Visa and Permits Task Force
(Signature over Printed Name)
Date Signed: ____________________

CERTIFICATION

I HEREBY CERTIFY that this application was APPROVED/DISAPPROVED by the Board of Commissioners during
its meeting on ____________________________.

This is to certify further that a ______________________ visa valid from _____________ to _____________
[DD-MMM-YYYY] [DD-MMM-YYYY]
is hereby authorized to be issued to applicant.

ERIC E. DIMACULANGAN
Application Number
Executive Director
Date Signed: ______________

VISA IMPLEMENTATION STAMP

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