Republic of the Philippines

Philippine Statistics Authority

Philippine Identification System
Zamboanga del Sur Provincial Statistical Office
143 V.Sagun Street, Balangasan Dsitrict, Pagadian City, Zamboanga del Sur

CONSENT FORM

I, ______________________________(name of parent/guardian), hereby give my

consent to the Philippine Statistics Authority (PSA) to register _________________________
(name of child) to the Philippine Identification System (PhilSys) Step 2 Registration.

This consent includes, but is not limited to:

a.) Permission to capture the demographic information including full name, date of birth,
place of birth, gender, full address and/or blood type.
b.) Permission to capture the biometric information of my child including both (left & right)
iris scans, fingerprint scans of 10 (Ten) functional fingers, and front facing photograph.

Name and Signature of Parent/Guardian: __________________________________

Date: _________________________