Professional Documents
Culture Documents
Department of Justice
Bureau of Immigration
Manila
NAME:_________________________________________________________________
Nationality:_____________________________________________________________
Checklist of Requirements
OATH OF ALLEGIANCE
I, ______________________________________________ solemnly
swear (or affirm) that I will support and defend the Constitution of the Republic of
the Philippines and obey the laws and legal orders promulgated by the duly
constituted authorities of the Philippines, and I hereby declare that I recognize
and accept the supreme authority of the Philippines and will maintain true faith
and allegiance thereto, and that I impose this obligation upon myself voluntarily
without reservation or purpose of evasion.
Affiant
SUBCRIBED AND SWORN TO, before me, this ____ day of __________
200__ in the City of_________________________________, Philippines, with
Passport No. ____________________ issued on ______________________ at
_______________________________.
ADMINISTERING OFFICER
Republic of the Philippines
Department of Justice
BUREAU OF IMMIGRATION
Intramuros, Manila
APPLICATION FORM
CITIZENSHIP RETENTION AND RE-ACQUISITION
(under R.A. 9225)
Indicate N/A if not applicable. Do not leave any space blank. Print all information.
Print legibly. Mark appropriate Boxes with Check
I. Personal Data:
FULL NAME: _______________________________________________________________________________
Birth date:
Civil Status
Nationality
Mode by which Philippine citizenship was acquired:
By birth By Marriage
By Election By Adoption
By Naturalization Others, specify:___________________
Mode by which Foreign citizenship was acquired: Date Acquired:_____________________
By Birth in a Foreign Country By Marriage
Born of an Alien Parent By Derivative Naturalization
By Naturalization Others, specify:__________________
Philippine Address:________________________________________________________________________
________________________________________ Telephone No.:__________________
Address Outside the Philippines:______________________________________________________________
________________________________________ Mobile No.:_____________________
E-mail Address:___________________________________________________________________________
Name of Spouse:_________________________________________ Nationality:_____________________
Fathers Name:__________________________________________ Birthdate:_______________________
Fathers Nationality at the time of Petitioners Birth:______________________________________________
Mothers Maiden Name:___________________________________ Birthdate:_______________________
Mothers Nationality at the time of Petitioners Birth:_____________________________________________
II. Immigration Status
Date of Latest Arrival:____________________________________ Validity:_______________________
Status of Admission Upon Entry:_____________________________________________________________
Passport No.:___________________________________________ Validity:_______________________
A.C.R. No.:____________________________________________ Date of Issue:___________________
I. C. R. No.:____________________________________________ Date of Issue:___________________
Re-entry Permit No.:_____________________________________ Date of Issue:___________________
III. Name of Person (s) Included as Dependent(s) in this Petition.