PM-NCR-03.01-F.19-B-R.
01
Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
NATIONAL CAPITAL REGION
CANCELLATION FORM
ALIEN EMPLOYMENT PERMIT (AEP)
Information of Foreign National:
Name (Last, First, MI)
Nationality: Date of Birth: Passport Number:
picture
Address in the Philippines: Email: Contact Number in the
Philippines:
AEP information: (for cancellation)
AEP Number: Date Issued: Validity Period
from: To:
COMPANY NAME (previous Company Address: Email address: Contact
employer) Number:
POSITION:
Name of Representative/Agent:
CURRENT EMPLOYER: (If applicable)
Name of Company: Address:
Contact Number: Email address:
Name of Representative/Agent:
This is to certify that all information stated above Certified true and correct:
are true and correct:
Signature over Printed Name of Employee Signature over Printed Name of Employer
(Foreign National)
Date: Date:
Please see checklist at the back.
PM-NCR-03-01-F-19-A-R.01
Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
NATIONAL CAPITAL REGION
G/F DOLE-NCR Bldg., 967 Maligaya Street, Malate, Manila
Telephone Nos. 400-6011 or 303-0364
CHECKLIST FOR AEP CANCELLATION
Instructions: Checkboxes below are to be filled out by the foreign national/previous employer
If requested by the Foreign National(FN):
1. Duly accomplished Cancellation Form;
2. Letter request addressed to the Regional Director. In case of unsurrendered AEP, state reason/s;
3. Original AEP card;
If lost, submit the following:
1. Notarized Affidavit of Loss;
2. Police Report; and
3. Photocopy of Passport Bio page.
4. Certificate of Employment or Clearance with signed received stamp;
5. Corporate ID of the signatory of clearance; and
6. Attach a copy of ID for Accredited Personnel/Employer's Authorized Representative.
If requested by the previous employer:
1. Duly accomplished Cancellation Form;
2. Letter request addressed to the Regional Director. In case of unsurrendered AEP, state reason/s;
3. Original AEP card;
If lost, submit the following:
1. Notarized Affidavit of Loss;
2. Police Report; and
3. Photocopy of Passport Bio page.
3. Corporate ID of the signatory of clearance; and
4. Attach a copy of ID for Accredited Personnel/Employer's Authorized Representative.
