Processor:

EMBASSY OF THE PHILIPPINES │ SINGAPORE

APPLICATION FOR PASSPORT RENEWAL Encoder:

Applic Date: SVC No.: PR - O.R. No.: Signing Officer:

Last Name │ Apelyido First Name │ Pangalan SR., JR., II, III

Middle Name │ Gitnang Pangalan Gender │ Kasarian

 Female  Male
Date of Birth │ Petsa ng Kapanganakan Place of Birth │ Pook ng Kapanganakan
Month: Date: Year:

Civil Status │ Katayuan Sibil

 Single  Married  Annulled  Widow/er  Divorced
Last Name First Name Middle Name Citizenship
SPOUSE

Address in Singapore Postal Code

Last Name First Name Middle Name Citizenship

FATHER

Maiden Last Name First Name Maiden Middle Name Citizenship

MOTHER

Filipino Citizenship acquired through │ Naging Pilipino dahil

 Birth  Election  Marriage  R.A. 9225  Naturalization  Other:

Immigration Status in Singapore │ Klase ng IC
 E Pass  S Pass  Work Permit  Dependant Pass  Student Pass
 Permanent Resident  Personalized Employment  Seafarer
Passport Number Date of Issue Place of Issue
CURRENT
PASSPORT

Occupation Email Address Mobile Number

Is this application for the

replacement of a lost passport? I swear under oath that all of the information are truthful, complete
and correct, and that all of my documents are authentic and valid.
 No  Yes
I am aware that I can hold only one Philippine passport at a time and
If yes, attach your Affidavit of Lost that making false statements and providing falsified or forged
Passport.
documents are punishable by law.
Do you hold a passport issued by
another country?
Applicant’s Signature over Printed Name
 No  Yes Applicant’s Signature over Printed Name
(Parent’s signature if Applicant is age 13 years or younger)
If yes, which country issued it?
Notes:

Applicant’s Signature over Printed Name