Consulate General of the Philippines

Consulate General of the Philippines

CONSULATE GENERAL OF THE PHILIPPINES

30 N. Michigan Ave. Suite 2100

Chicago, IL 60602

Tel. No. (312) 332-6458

REPORT OF BIRTH

CHILD BORN ABROAD OF FILIPINO PARENT OR PARENTS

Chicago, ______

(Date Reported)

Name of Child (in full) : ______Sex : ______
Date of Birth : ______Hour : ______Minutes: ______
Place of Birth (in full) : ______
Civil status of parents : ______
FATHER
Fullname: ______
Citizenship: ______
(at the time of child’s birth)
Occupation: ______
Present Address: ______
______
Birthplace: ______
Passport No.: ______
Issued by: ______
Dated: ______Valid to ______
Precise periods and places of Philippine residence: ______
______
______/ MOTHER
Fullname: ______
Name before marriage: ______
Citizenship: ______
(at the time of child’s birth)
Present Address: ______
______
Birthplace: ______
Passport No.: ______
Issued by: ______
Dated: ______Valid to ______
Precise periods and places of Philippine residence: ______
______
______
Place and date of Marriage: ______
Number of previous children: ______Number now living: ______
Name and address of physician or nurse : ______
______
______
(Signature of parent or legal guardian)
(WHEN REPORTED BY MAIL, SIGN IN THE PRESENCE OF TWO WITNESSES)
Declared in our presence this ______day of ______20 ___ at ______
(Witness) ______
(Address) ______
(Witness) ______
(Address) ______/ (WHEN REPORTED IN PERSON, USE THIS FORM)
Subscribed and sworn to before me
this ______day of ______20 ___ at the Philippine Consulate General, Chicago.

FOR OFFICIAL USE ONLY

This birth was registered on ______at the Philippine Consulate General, Chicago under No. ______of the Civil Registry Book. This report has been executed in four (4) copies, with a copy each furnished to the parents, the Civil Registrar General and the Department of Foreign Affairs, Manila, and copy placed in the files of the Consulate, together with the supporting documents.

Fee:$25.00

O.R. No.:

Service No.:

Doc No.:

REQUIREMENTS TO REPORT BIRTH

1.Accomplish Report of Birth form (one original and 3 photocopies)

  1. Original and three (3) photocopies of Birth Certificate of applicant
  1. Three (3) photocopies of Philippine passport of either parent or Naturalization papers (for dual citizens, copy of Oath of Allegiance and Order of Approval)
  1. Three (3) photocopies of parent’s marriage certificate
  1. Three (3) photocopies of U.S. passport of applicant, if any
  1. Fee: $25.00 (payable in cash when personally applying, or in money order or cashier’s check payable to the Philippine Consulate General when applying by mail or by courier; personal checks and personal money orders are not accepted)
  1. Pre-paid return envelope

Note:

The Consular Officer reserves the right to require additional proof or documents from applicant, to prove his/her citizenship or identity pursuant to the Philippine Passport Law (R.A. 7157).

Only Birth Certificates from the following states are accepted by the Consulate:

ArkansasMississippi

IllinoisMissouri

IndianaNebraska

IowaNorth Dakota

KansasOhio

LouisianaOklahoma

MichiganSouth Dakota

MinnesotaWisconsin

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