Docstoc

dual citizenship form

Document Sample
dual citizenship form Powered By Docstoc
					        PHILIPPINE CONSULATE GENERAL                                                        Tel No. (604) 685-1619 /685-7645
         700 W. Pender Street, Suite 1405                                                             Fax No. (604) 685-9945
         Vancouver, BC V6C 1G8 Canada                        E-mail: vancouverpcg@telus.net Website:www.vancouverpcg.net

     APPLICATION FOR CITIZENSHIP RETENTION AND RE-ACQUISITION under R.A. 9225


                                        4.5 cm X 3.5 cm            4.5 cm X 3.5 cm
                                             PHOTO                      PHOTO

                                            ROYAL BLUE                 ROYAL BLUE
                                          background taken           background taken
                                          within last six (6)        within last six (6)
                                           months, without            months, without
                                         eyeglasses, clearly        eyeglasses, clearly
                                        showing the full front     showing the full front
                                           view of the face           view of the face




Please read and follow instructions on reverse side. Print all information legibly. Do not leave any space blank.
Indicate “N/A” if not applicable. Mark appropriate Boxes    with X.

I. PERSONAL DATA
   1. NAME (as written on Philippine Birth Certificate or Report of Birth):
      LAST NAME (surname or family name) ___________________________________________________
      FIRST NAME (given name/s) ___________________________________________________________
      MIDDLE NAME (mother’s maiden surname) ________________________________________________
   2. Date of Birth: ____________________ 3. Place of Birth: ____________________________________
    4. Civil Status:                                                              5. Gender:
                         Single                  Married                                  Male
                        Widow/er                 Divorced                                 Female
                         Others
   6. Present Occupation : __________________________________________________________________
   7. Address in the Philippines: ( house no., street, town or city, zip code) _______________________________
     ____________________________________________________________________________________
  8. Address in Canada or Country of Residence: (house no., street, city, province, postal code)______________
     ____________________________________________________________________________________
  9. Mailing Address : _____________________________________________________________________
     ____________________________________________________________________________________
 10. Home Telephone No: __________________________ 11. Work Telephone No: _________________
 12. E-mail Address/Fax No: _______________________________________________________________
 13. Name of Spouse : _______________________________ 14. Nationality : _______________________
 15. Name of Applicant’s Father: ____________________________ Birthdate : _______________________
 16. Father’s Citizenship at the time of applicant’s birth: __________________________________________
 17. Name of Applicant’s Mother: ___________________________ Birthdate : _______________________
 18. Mother’s Citizenship at the time of applicant’s birth: __________________________________________

II. IMMIGRATION STATUS
   19. Current Foreign Citizenship : ___________________________________________________________
   20. Mode of Acquisition of Foreign Citizenship : _______________________________________________
   21. Date of Acquisition of Foreign Citizenship: ________________________________________________
   22. Foreign Passport No.: ________________________________________________________________
   23. Place Issued : _____________________________ 24. Date Issued : ___________________________
   25. Previous Philippine Passport no.: ___________Place of Issue :___________ Date of Issue :_________

III. NAME, PLACE AND DATE OF BIRTH OF UNMARRIED CHILDREN BELOW 18 INCLUDED AS
     DEPENDENTS IN THIS PETITION:
                Name                         Place of Birth            Date of Birth
 ________________________________                   ______________________________              _____________________
 ________________________________                   ______________________________              _____________________
 ________________________________                   ______________________________              _____________________
 ________________________________                   ______________________________              _____________________
 ________________________________                   ______________________________              _____________________
                                                  CERTIFICATION

        I hereby certify under oath that all the information in this general application form composing of two
pages including the page on which this Certification is written are true and correct information about myself
as an applicant. I further warrant that I have complied with all the requirements of the Bureau of
Immigration with respect to my application for the issuance of Identification Certificate (I.C.) and that I
submitted duly certified copies of documents issued under the official seal of the officer having legal custody
of their originals in the Philippines and foreign documents duly authenticated by the consular/embassy
official in the foreign service of the Philippines in the foreign country, in compliance with the requirements
of the Bureau of Immigration. I understand that my application will not be processed by the Bureau if it
finds any statement herein to be false, if any document submitted is found to have been falsified, or if I fail to
comply with all the requirements of the Bureau of Immigration with respect to my application / petition
without prejudice to whatever action (s) the Bureau of Immigration shall take in accordance with applicable
laws of the Republic of the Philippines.

Date executed : ______________________________
Place executed : _____________________________

                                                                  __________________________________________
                                                                         (Applicant’s Signature over Printed Name)


          SUBSCRIBED AND SWORN to before me this _________ day of _________________________, at
the Philippine Consulate General, Vancouver, British Columbia.



                                                                   _________________________________________
                                                                                 Administering Officer
Doc. No: __________________
Page No: __________________
Book No: __________________
Series No: _________________
Service No: ________________
O.R. No:___________________
Fee Paid: __________________
__________________________________________________________________________________________________________

PLEASE SUBMIT THREE (3) PHOTOCOPIES OF EACH OF THE REQUIRED DOCUMENTS

REQUIREMENTS:
  Original Birth Certificate authenticated by the National Statistics Office (NSO)
* Marriage Certificate (for married female applicant)
* Death Certificate of spouse (if applicable)
* Appropriate divorce decree or court order on the annulment of marriage (if applicable)
  Three (3) recent 4.5 cm X 3.5 cm photographs (colored with ROYAL BLUE background)
  Fee of CAN $57.50/applicant - in money order or bank draft only made payable to the Philippine Consulate General
* Photocopy of Canadian passport
* Photocopy of Citizenship Card/ID
* Photocopy of Certificate of Oath Taking as a Canadian
* Photocopy of old Philippine passport
  *(original shall be presented to the evaluating officer)

OTHER SUPPORTING DOCUMENTS:
* Certificate of Non-availability of Birth Record (if born before 1950) from the Local Civil Registrar or from NSO
* Baptismal Certificate/Joint Birth Affidavit
* Marriage Certificate of parents
* Order of adoption, if applicable
  *(original shall be presented to the evaluating officer)

DEPENDENT (Two photocopies of the following required documents)
    One (1) recent 4.5 cm X 3.5 cm photographs (colored with ROYAL BLUE background)
    * Copy of foreign passport
    * Copy of Birth Certificate
    Fee of CAN$ 28.75 (certified cheque or postal money order)
     *(original shall be presented to the evaluating officer)

INSTRUCTIONS:
* Application form must be duly accomplished and signed. Incomplete information on the application form may cause
  delay in the processing of application.
* All requirements should be submitted with the duly accomplished application form.
* If the documents are complete and satisfactory, applicant will be informed, of the schedule for taking the Oath of
  Allegiance. PERSONAL APPEARANCE IS REQUIRED IN TAKING THE OATH.
* Female applicants who are married should apply in their maiden name

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:4
posted:9/30/2012
language:Unknown
pages:2