NAIA ACCESS REQUEST FORM

Date: Company (Requestor): Requestor Type:

❑ Airline/Ground Handler ❑ Diplomat ❑ Medical
Nov 3, 2023 RCBC ❑ Tenant/Concessionaires ❑ Gov’t Agency
❑ Contractor/Provider ❑ Others:_______________
Requesting access Validity Date: Gate of Entry/Exit: Requested Access
permit for: From:______________________
Nov 3, 2023 ❑ Terminal 1 ❑Ramp Gate 1 Inner Area/s:
To:________________________
Nov 30,2023 ❑ Terminal 2 ❑Ramp Gate 2 Inner
❑ Terminal 3 ❑South Gate T2
❑ Personnel
Validity Time: ❑ Terminal 4 ❑Delta Gate
❑ Vehicle/s From:______________________
9AM ❑ North Gate101 ❑ ICT
To:________________________
8pm ❑ Crash Gate 1 Inner/Outer
❑ Others–specify: _______________
Scope of access:
❑ Maintenance* ❑ Pull Out* ❑ Media Event
❑ Repair* ❑ Diplomatic Related Event ❑ Meet & Assist
❑ Installation* ❑ Company Official Even ❑ Others -specify: ____________________________________________
❑ Delivery* ❑ Media Even ❑ Remarks: ________________________________________________
*For Maintenance/Repair/Installation/Delivery/Pull-out kindly attach the list of equipment, tools and/or items for delivery/pull-out.
Personnel Information (Required ID/Access pass)
Names
1. Luvimin Medina 8.
2. Juanito Rivera III 9.
3. Johrenz Joseph Plaida 10.
4. Michael Escote 11.
5. Romeo Dela Cerna 12.
6. 13.
7. 14.
Flight Details
Departure Flight: Arrival Flight:

Departure Time: Arrival Time:

Vehicle Information (Please attach list of vehicles if more than 5)

Type/Year/Make/Model Plate No. Company Name Name of Driver/s
1
2.
3.
4.
5.

Important Reminders:
1. Accomplish the attached form or this link https://forms.gle/wFCQ8FMsEgBWiMfw9 or the QR code below.
2. Submission of requests must be 3 working days before the actual schedule.
3. This form is only applicable to all requests for Visitor’s, Official Business and On-Duty passes.
4. Administrative requirements and fees shall apply in reference to MC 05 of 2013 and MC 14-H of 2010.
5. Upon completion of all details, kindly submit the signed form to naiaaccess@miaa.gov.ph with subject format:
Company Name_Access _Date of Access e.g. Cebu Pacific_Access_Dec 10 2022

Requested by:

GLEN B. OSERA
______________________________________
(Signature over Printed Name and Position Title)
Authorized Signatory Only