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REPUBLIC OF THE PHILIPPINES PHILIPPINE CONSULATE GENERAL HONG KONG E-PASSPORT APPLICATION

PREFERRED APPOINTMENT DATE: _____________________ TIME: 9am 10am 11am 12nn 1pm 2pm 3pm

LAST NAME / APELYIDO MIDDLE NAME / GITNANG PANGALAN / / Day Month Year DATE OF BIRTH / PETSA NG KAPANGANAKAN
Civil Status: Single Married Widow/er

FIRST NAME / PANGALAN (JR. / II / III) PLACE OF BIRTH / POOK NG KAPANGANAKAN GENDER / KASARIAN: MALE FEMALE

Legally Separated Citizenship:

Annulled

Name of Wife/Husband: Last Name Hong Kong Address: E-mail Address: Present Occupation: Philippine Address: Name of Father: Last Name Maiden Name of Mother: (Pangalan nung dalaga) Maiden Last Name
Citizenship Acquired By: Birth Election R.A. 9225 Others: Marriage

First Name

Middle Name

Mobile No.: Tel. No.: Tel. No.: Citizenship: First Name Middle Name Citizenship: First Name
Naturalization

Maiden Middle Name


Purpose Of Travel: Tour Seaman Study Work Business Others Migration

Are you a holder of foreign passport? If Yes, from what country?

Yes

No

Have you ever been issued a Philippine Passport? If Yes, Latest Passport Number? Date of Issue: Place of Issue: This serves as an Affidavit of Loss Lost Passport Number: Issued on: Date lost: Lost due to:

Yes

No

This serves as Affidavit of Support and Consent to Travel (for Applicants below 18 years old ONLY) Name of minors traveling Companion: Companions Relationship: Address / Contact Number: Signature of Parent or Legal Guardian

Issued by:

Signature of Applicant

I SOLEMNY SWEAR that: 1) I am a Filipino citizen; 2) The information I provided in this application is true and correct; 3) The supporting documents attached are authentic; 4) I have not been issued a passport under any other name; 5) I am aware that under the law, I am allowed to hold only one Philippine passport at any given time; 6) I am aware that making false statements and furnishing falsified or forged documents are punishable by law.

Signature of Applicant

FOR ADMINISTRATIVE USE ONLY:


Processor: RECEIVED CANCELLED PASSPORT: REMARKS: To save a trip to the Consulate, fax or e-mail this form together with a photocopy of your HKID and pages of your passport containing your name, photo and current Hong Kong work visa. You will receive an Appointment Slip by fax or e-mail. On the date and time of appointment, bring to the Consulate the Appointment Slip, your passport and the documents that you submitted by fax or email. Fax: 2866-9885 E-mail: passport@philcongen-hk.com Encoder: Signing Officer: RECEIVED NEW PASSPORT: