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APPLICATION FOR PHILIPPINE PASSPORT
THIS FORM IS NOT FOR SALE
DEPARTMENT OF FOREIGN AFFAIRS
PHILIPPINE EMBASSY IN LONDON | UNITED KINGDOM
Last Revision: October 2022
INSTRUCTIONS:
Read CAREFULLY.
Please PRINT ENTRIES legibly using black or blue ink only.
Supply the necessary information and indicate “N/A” for entries with no answers.
Tick boxes as appropriate.
CAPTURE SITE PRE-PROCESSING (Do not write on this part)
Appointment verification | Remarks | Signing Officer:
Mobile machine ☐OTSP ☐Dual
CURRENT PHILIPPINE PASSPORT DETAILS
1.Passport number:
2.Date of issue: (ex. January 01, 2019)
3.Place of issue: (Issuing Authority)
APPLICANT’S INFORMATION
4.Last name:
5.First name(s):
6.Middle name or
Maiden last name:
No middle name:
7. Sex:
MALE FEMALE
8. Date of birth: (ex. January 01, 2019)
10. Civil status:
SINGLE
MARRIED
WIDOW/ER
ANNULLED/NULLIFIED
DIVORCED
11. How did you acquire Philippine
citizenship?
BIRTH
NATURALIZATION
RE-ACQUISITION (RA 9225)
ELECTION
LEGISLATION
15. Name of applicant’s spouse (Last name, First name, Middle name):
17. Applicant opted to use maiden name NO YES If YES, applicant to sign here:
APPLICANT’S CONTACT INFORMATION
18. Country of residence:
19. State/Province:
20. City/Town:
21. No./Street/Apt/Floor:
22. Postal code:
23. Options for passport releasing:
PICK UP MAIL** (Please provide mailing stamps)
24. Telephone/Mobile number:
25. E-mail address:
26. Person to contact in case of emergency:
APPLICANT’S PARENTAL INFORMATION
28. Status of birth:
MARITAL NONMARITAL
29. FATHER
Last name:
33. MOTHER
Maiden Last name:
30. First name:
34. First name:
31. Middle name:
35. Middle name:
32. Citizenship:
(at time of applicant’s birth)
36. Citizenship:
(at time of applicant’s birth)
ADULT
MINOR*
NEW
RENEWAL
LOST PASSPORT
What year?
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*FOR APPLICANT BELOW 18 YEARS OLD ONLY
37. Personal email of parent/guardian:
38. Mobile number of parent/guardian:
39. Is there any court order or legal arrangements
pertaining to the child? If YES, please provide
pertinent documents. NO YES
40. Is the applicant currently the subject of an adoption process or
partially/fully in the care of an orphanage? NO YES
If YES, please provide pertinent documents.
DECLARATION OF APPLICANT OR PARENT/GUARDIAN OF MINOR
41. I HEREBY DECLARE AND AFFIRM that 1) I am a Filipino citizen. 2) The information provided in this application is true and correct. 3) The supporting
documents attached are authentic. 4) I consent to the verification by the Philippine Government of the information I provided to establish my personal particulars,
and further consent to its use for any lawful purpose. 5) I am aware that the information provided in this application will be treated in accordance with relevant
privacy regulations. 6) I am aware that under the law, I am allowed to hold only one valid regular Philippine passport at a given time. 7) I am aware that making
false statements in this passport application and furnishing falsified or forged documents are punishable by fine or imprisonment, and grounds for suspension
or denial of application. 8) I understand and accept that the release of the passport could be subject to delay due to unforeseen events beyond the control of
the Department of Foreign Affairs.
_____________________________________________________ ______________
42. SIGNATURE OVER PRINTED NAME OF APPLICANT OR PARENT/LEGAL GUARDIAN 43. DATE SIGNED
(DO NOT SIGN APPLICATION UNTIL REQUESTED TO DO SO BY THE AUTHORIZED OFFICER)
**WAIVER: Mailing and Surrendering of Philippine Passport
☐ 44.I willfully and voluntarily surrender my valid Philippine passport
at the Philippine Embassy in London, United Kingdom with the understanding that this
valid p
assport will be cancelled only upon the issuance of my new Philippine passport. I also acknowledge that by surrendering this Philippine passport, I
may be restricted at terminals in my domestic and/or international travels, if I am not able to present a valid passport to immigration/airport officials.
I also hereby attest that I willfully decided to have my passport delivered to my declared address at the time of this application by mail or express courier
of my preference. I take full responsibility for this decision, and I acknowledge the risks associated with the delivery of said passport by a third party service
provider that may occur from the time it leaves the Embassy until my passport is delivered to my address.
_________________________________________________________________________
45. SIGNATURE OVER PRINTED NAME OF APPLICANT OR PARENT/LEGAL GUARDIAN
CURRENT PASS
☐ Passport intact
☐ Damaged passport
• Affidavit of explanation
PORT STATUS:
☐ Lost valid passport ☐ Lost expired passport
• Affidavit of loss • Affidavit of explanation
• Police report in English
PROOF OF PHILIPPINE CITIZENSHIP:
☐ Birth certificate from Philippine Statistics Authority (PSA)
☐ Certificate of Naturalization
☐ Election of Philippine Citizenship
☐ Identification Certificate of Citizenship
☐ Report of Birth (ROB)
☐ Others:
IDENTITY DOCUMENT SUBMITTED:
☐ COMELEC Voter’s ID
☐ LTO Driver’s License
☐ Unified Multipurpose ID
☐ (UMID) PWD ID GSIS / SSS ID Senior Citizen’s ID
☐ Professional Regulatory Commission
☐ Others:
SUPPORTING DOCUMENTS:
☐ Marriage Certificate from PHL Statistics Authority (PSA)
☐ Voter’s Registration Record
☐ Court Order
☐ NBI Clearance
☐ Others:
SUPPORTING DOCUMENTS FOR MINOR:
☐ Parent/Guardian’s ID
☐ School Identity Card
☐ DSWD Clearance
☐ Affidavit of Consent to Travel/Special Power of Attorney
☐ Court Decree on Adoption/Guardianship
☐ Others:
Remarks/Watchlist Verification:
Returned Cancelled Passport (Parents or Legal Guardian’s Signature for Minor):
PROCESSOR’S SIGNATURE:
ENCODER’S SIGNATURE:
OFFICIAL RECEIPT/PAYMENT SLIP NO:
DATE OF TRANSACTION:
https://londonpe.dfa.gov.ph
*FAFORM01SF*
F A F O R M 0 1 U K
STOP! DO NOT WRITE BELOW THIS LINE. OFFICIAL USE ONLY.
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