AUTHORIZED PERSONS OUTSIDE RESIDENCE (APOR)

APPLICATION FORM

Control # ___________________

PLEASE FILL IN COMPLETE INFORMATION FOR YOUR REQUEST OF ENTRY FOR THE
TRANSIT IN AND THROUGH KANANGA LEYTE.

NAME:______________________________________________________________________________
(Surname) (First Name) (Middle Initial)

PRESENT ADDRESS:___________________________________________________________________
(House/Block/Lot#) (Street)

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(Subdivision/Village) (Barangay)

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(City/Municipality) (Province)

CONTACT NUMBER: ___________________________ BIRTHDATE:___________________________

DATE OF TRAVEL:______________ORIGIN: ______________ # OF DAYS IN KANANGA:________

HOURS OF WORK: ___________ COMPANY NAME: _____________________________________

COMPANY CONTACT PERSON & NUMBER: ____________________________________________

CONTAINMENT FACILITY/ HOTEL ADDRESS:_____________________________________________

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NATURE OF WORK/SERVICE: _________________________________________________________

MODE OF TRANSPORTATION: _______ Land trip ________ Ship________ Plane ______ Others

PRIVATE VEHICLE: (If any, please provide plate number, unit and model)

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OTHERS/REMARKS:
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