ARMED FORCES OF THE PHILIPPINES

ID APPLICATION FORM
RESERVIST
ACTIVE OFFICER / ENLISTED PERSONNEL

ID NO.:___________ Control No.:_____________ REQUIREMENTS

1. Application form duly accomplished
FIRST NAME: endorse by their Admin Officer and
approved by their respective
RssCom Adjutants.
MIDDLENAME: 2. ORDERS: Appointment, Promotion,
LASTNAME: Assignment applicable.
3. Present old AFP ID, if lost attached
APPLICABLE FOR MARRIED FEMALE
Affidavit.
MAIDEN’S MIDDLENAME
MAIDEN’S LASTNAME

RANK: BRSV

AFPSN: PASTE
Recent (15 days old) 2x2 color
UNIT ASSIGNMENT: picture In GOA Uniform, w/ white
background no mustache/ beard, in
HOME ADDRESS: proper haircut, authorized
nameplate must be visible In
proper placement

WEIGHT: kgs. HEIGHT: cms. BLOOD TYPE:

OTHER IDENTIFYING DATA:

RELIGION: TIN:

PHILHEALTH NO.
ETAD/ETE (DD-MMM-YYYY)

DATE OF BIRTH: (DD-MMM-YYYY) : GENDER:

PLACE OF BIRTH: KEEP SIGNATURE INSIDE THE BOX

(PLEASE USE BLACK SIGN PEN
MARITAL STATUS: SEPERATED BY
(PLEASE CHECK ONE) SINGLE MARRIED WIDOWED COURT ORDER ANNULLED

NAME OF PARENTS FATHER MOTHER MAIDEN NAME

FIRSTNAME:

MIDDLENAME:
LASTNAME:

CRN (IF PPLICABLE)

OCCUPATION: RIGHT THUMBMARK

PERSON TO BE NOTIFIED IN CASE OF EMEGENCY AND RELATIONSHIP

ADDRESS OF PERSON TO BE NOTIFIED

CONTACT NO:

Statement Of Consent
I declare that I am fully aware that the above data shall be used for securing my Common Reference Number (CRN) for the Unified
Multi Purpose ID (UMID) System or updating my personal data and that it shall form part of the CRN Registry. I trust that the above
data shall remain confidential hence I give my consent tha the data be secured and accessed for sunsequent validation verification,
and other purposes consistent with the objectives of the UM-ID System under Executive Order No. 420 only. I further affirm that all
statements/data, which appear in this registration form and made by me are true and complete to the best of my knowledge and
belief.
Date Signed Signature over Printed Name

ENDORSED BY: APPROVED BY:

PROCESSED BY :
SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME
VERIFIED BY :
 RANK BR OF SVC TAG, AFP/ MAJ SVC ADJ
RECORDED BY :

UNIT ADJ/ADMIN O
FrmCd:200701
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ID no. Date: ID no. Date:

(c/o OTAG-PCRD) (c/o OTAG-PCRD)

Firstname/Last name

Control No: Control No:

(c/o GMP) (c/o GMP)
1) Paid the amount of Seventy Pesos (PhP70.00) for AFP ID.
2) Please present this when claiming your AFP ID on ________________ Received the amount of SEVENTY PESOS (PhP70.00) for payment of AFP ID
Cashier’s Signature Cashier’s Signature
CLAIM STUB CASHIERS COPY