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EMBASSY OF THE PHILIPPINES6-8 SUFFOLK STREET

LONDON SW1Y 4HG

UNITED KINGDOM

E-PASSPORT APPLICATION

PLEASE PROVIDE CORRECT INFORMATION AND DO NOT LEAVE SPACES BLANK

______________________________________________________LAST NAME/ APELYIDO

______________________________________________________FIRST NAME/ PANGALAN (Jr. / II / III)

______________________________________________________MIDDLE NAME/ GITNANG PANGALAN

_______________ / _________________________ / ___________Day Month Year

DATE OF BIRTH/ PETSA NG KAPANGANAKAN(Ex. 01 January 2013)

______________________________________________________PLACE OF BIRTH/ POOK NG KAPANGANAKAN

GENDER/ KASARIAN: MALE FEMALE

Civil Status: Single Married Widow/er Legally Separated Annulled Divorced

Name of Wife / Husband: _______________________________________________First Name Middle Name Last Name

Citizenship : _______________________

Complete U.K. Address: ____________________________________________________________ Tel. No.: ______________________

Present Occupation: _______________________________________________________________ Mobile No.: ______________________

Work Address: _______________________________________________________________________________________________________

E-mail Address: __________________________________________________________________ Tel. No.( at work): ________________

Name of Father: _________________________________________________________________First Name Middle Name Last Name

Citizenship : ______________________

Maiden/SingleName of Mother : _________________________________________________________________ Citizenship: ______________________

First Name Middle Name Last Name

Contact Person and his/her address in the Philippines (in case of emergency) ___________________________________________________________________________________

_____________________________________________________________________________________________________________________

Philippine Citizenship Acquired By:

Birth Election Marriage Naturalization

R.A. 9225

Others_________________

Immigration Status in the U.K.:

Visitor Seaman Business Resident

Student

Work Permit

Others _______________Are you a ci ti zen of anot her count ry?Yes NoIf yes, from what country? _____________________

Have you ever been issued a Philipp ine Passport? Yes No

If yes, Latest Passport Number? ____________________________Date of Issue: _____________ Place of Issue: ______________

This serves as an Affidavit of Supp ort and Consent to Travel(for Applicants below 18 years old ONLY)

Name of Minors travelingCompanion: ________________________________________

Companio ns Relationship: _________________________________________Add ress/Con tactNumber: _________________________________________

__________________________________________Signature of Parent or Legal Guardian

This serves as an Affidavit of Loss

Lost Passpor t Number: _________________________________________

Issued on: _____________________Issued By: _________________________

Date Los t: _______________________________________________________

Lost due to: ______________________________________________________

________________________________________Signature of Applicant

I SOLEMNLY 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 un der any other name. 5) I am aware that under the law, I am allowed to hol d only on e Philippine passpor t at any given ti me. 6) I am aware that makingfalse statements in passport application and furnishing falsified or forged documents in support thereof are punishable by law.

__________________________________________________Signature of Applicant (parents to sign for minor children)

REMARKS:

FOR STRICT COMPLIANCE: Please print name and affix initials.Processor: Encoder: Signing Officer:

RECEIVED OLD/CANCELLED PASSPORT: RECEIVED NEW PASSPORT:

FOR ADMINISTRATIVE USE ONLY:

For details, please visit http://www.philembassy-uk.org

NOTFORSALERESET

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REQUIREMENTS FOR ALL APPLICANTS(E-PASSPORT)

Personal Appearanceis required Duly accomplished application form. Other supporting documents that may be required (please refer to the list below.) The passport fee is 43.00 payable in cash or Bri tish p ostal order.

(We do not accept personal cheques, debit/credit cards for payment) .

ADDITIONAL REQUIREMENTS FOR PASSPORT RENEWAL

1. Applicants old passport2. Photocopy of old passports personal data page.

3. If passport being renewed is the old brown passport or machine readable passport (MRP), submit NSO authenticated BirthCertificate and other supporting documents with complete middle name and place of birth***.4. Former Filipinos who have re-acquired Philippine citizenship must bring copies of their Oath of Allegiance.

ADDITIONAL REQUIREMENTS FOR FIRST TIME APPLICANTS(CHILDREN BORN IN THE UNITED KINGDOM OR IRELAND)

1. The original and 4 (four) photocopies of the childs birth certificate bearing both parents names. Four (4) completed Reportof Birth Forms which are available at the Embassy or at our website. The Report of Birth fee is 18. A late registration feeof 18is added if the child had been born for more than a year.

2. Four (4) photocopies of the data page of the parents valid passports.Note: If child was born in another country, submit Birth Certificate and NSO authenticated Report of Birth of the child orReport of Birth, which has already been processed by the Philippine Embassy/Consulate which has jurisdiction over thecountry of birth of the child.

ADDITIONAL REQUIREMENTS FOR MARRIED WOMEN WHO WISH TO USE SURNAME OF SPOUSE IN THEIRPASSPORTS

(Note: The Embassy no longer processes applications for amendment of name in

passports. Applicants are required to renew the passport instead.)

1. If married in the Philippines, the original and a photocopy of the marriage certificate (authenticated by the NationalStatistics Office). A copy of husbands valid passport or birth certificate.

2. If marriage was celebrated in the United Kingdom or Ireland, (a) the original and four (4) copies of the Marriage Certificatefitted and reduced in size on A4 size paper, (b) four (4) duly accomplished Report of Marriage forms (which are available atthe Embassy and at the Embassy website), (c) four (4) photocopies of the passports of the husband and wife. The Reportof Marriage fee is 18. If the marriage had been solemnized for more than a year prior to the filing of Report of Marriage,there is an additional fee of 18for late registration.

If marriage was celebrated in another country, submit marriage certificate and NSO authenticated Report of Marriageor Report of Marriage, which has already been processed by the Philippine Embassy/Consulate which has jurisdictionover the country where the marriage was celebrated.

In case of death of previous husband, applicant must provide the original and four (4) copies of the NSO authenticateddeath certificate of the late husband.

In case of divorce or annulment of marriage, applicant must provide the original and four (4) photocopies of the NSO

authenticated marriage certificate/Report of Marriage with annotation of divorce or annulment. Note: Female applicantmay have her name changed to that of her second spouse only if the petitioner of the divorce of the previous marriageis the foreign spouse. A foreign judgment of divorce must also be passed on judicially by a Philippine court to prove itsvalidity. A civil action for judicial confirmation/enforcement must be filed first at the Regional Trial Courts in thePhilippines.

ADDITIONAL REQUIREMENTS FOR THE REPLACEMENT OF LOST PASSPORTS

Please note that there is a 21-day waiting period for this service, prior to actual processing of the passport.1. Two (2) completed passport application forms.2. Two (2) copies of the affidavit of loss. This form is available at the Embassy and at the Embassy website.3. Photocopy of the lost passport, if available. Applicant must present NSO authenticated birth and marriage certificates,

and other identification cards/supporting documents***.4. Other documents may be required if needed.5. The total fee for the replacement of a lost passport is 87.00 or 130.00, if the passport that was lost is an e-passport

(includes 4.00 verification fee).

***LIST OF OTHER SUPPORTING DOCUMENTS REMINDERS

PRC/IBP ID Seamans BookLand Title Voters Registration RecordDrivers LicenseGovernment Service RecordOld SSS-E1 formTranscript of RecordsBaptismal Certificate

Passports unclaimed after six (6) months will be cancelled perDepartment Order No. 37-03.

The Embassy is authorized to reject applications notsupported by sufficient documentary requirements.

The Philippine Embassy Consular Section is located at 6 Suffolk Street, London, SW1Y 4HG. The Embassy is open from 9:00am to 1:00pm and 2:00 to 5:00pm, Mondays thru Fridays, except holidays.

TO CLAIM PASSPORTS:

Passports may be claimed in person by the applicant after 6-8 weeks from the date of application or completion of the computergenerated form for the passport. Applicants will be notified when processed passports are ready for collection.

Passport may be posted to the applicant by the Embassy upon submission of a self-addressed, pre-paid special deliveryenvelope at the time of the application.

Website: http://www.philembassy-uk.org