Pasuguan Ng Republika Ng Pilipinas

THIS FORM IS NOT FOR SALE

□ NEW □ RENEWAL ePassport Application Form

□ REPLACEMENT OF LOST PASSPORT PLEASE PROVIDE CORRECT INFORMATION AND DO NOT LEAVE SPACES BLANK

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MALE FEMALE

Address in Austria/Croatia/Slovakia/Slovenia/Germany:______

Address in Philippines: ______

Mobile Number: ______Email Address: ______Present Occupation: ______

Name of Present Employer:______Work Address: ______Tel. No. ______

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

Name of Father:First: ______Middle:______Last:______Citizenship: ______

Single Name of Mother:First: ______Middle:______Last:______Citizenship: ______

Name of Spouse:First: ______Middle:______Last:______Citizenship: ______

IN CASE OF EMERGENCY, PERSON TO BE NOTIFIED:

• In the Philippines:

Name: ______Address: ______Relation: ______

E-Mail Address: ______Tel. No: (0063)______Mobile Number: ______

• In Austria/Croatia/Slovakia/Slovenia/Germany

Name: ______Address: ______Relation: ______

E-Mail Address: ______Tel. No: ______Mobile Number: ______

• Are you a holder of a Foreign passport? Yes No

• Would you like to receive Consular information or Updates/News from the Philippine Embassy via e-mail?

• Have you ever been issued a Philippine Passport?

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 under any other name. 5) I am aware that under the law, I am allowed to hold only ONE Philippine Passport at any given time. 6) I am aware that making false statements in passport application, furnishing falsified or forged documents in support thereof are punishable by law.

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Date of Application Signature of Applicant

REQUIREMENTS FOR ePASSPORT ISSUANCE

First-time Applicants (Infants/Children BORN in Austria, Croatia, Slovakia, Slovenia)

Personal appearance of the applicant;

Accomplished ePassport Application Form;

Three (3) Passport Size Pictures- White Background;

Birth Certificateof the applicant – Original International Versionand photocopy of all the pages. (Formblatt A – For Austria);

Marriage Contract or Report of Marriageof the parents of the applicant, if applicable – Original and a photocopy;

Any document showing mother’s maiden surname (e.g. birth certificate, voters’ ID, school records, driver’s license) – Original and a photocopy;

Parent’s latest passports - Original and photocopiesof the datapage and last page;

ePassport Fee: EUR 54.00;

Accomplished Report of Birth Form. Report of Birth Fee: EUR 22.50.

Notes:

For Infants/Children born in Austria, Croatia, Slovakia and SloveniaReport of Birth must be filed at the Philippine Embassy together with ePassport application;

Report of Birth Form and requirements are available at the website of the Philippine Embassy at

RENEWAL of Expired/Expiring Passport

Personal appearance of the applicant;

Accomplished ePassport Application Form;

Three (3) Passport Size Pictures- White Background;

Current passport – Original and Two (2) photocopies;

• If BROWN passport: Copy of the Data Page and Last Page;
• If GREEN passport:Copy of the Data Page and Last Page;
• If current passport has an AMENDMENT, submit also a photocopy of the page showing amendment.

If current passport is brown, present documentary proof of middle name (e.g. birth certificate, marriage contract, voters’ ID, school records, driver’s license) – Original and photocopy;

ePassport Fee: EUR 54.00.

REPLACEMENT of Lost or Damaged Passport

Personal appearance of the applicant;

Accomplished ePassport Application Form;

Three (3) Passport Size Pictures- White Background;

Copy of lost passport or remains of damaged passport;

(If none, submit Birth certificate – original or authenticated copy, and photocopy)

Affidavit of Loss or Damage stating in detail the circumstances of loss or damage. Affidavit fee: EUR 22.50;

Police Report with English translation. (For Lost passports only);

If lost/damaged passport is brown, present documentary proof of middle name (e.g. birth certificate, marriage contract, voters’ ID, school records, driver’s license) – original and photocopy;

Lost ePassport Fee: EUR135.00.

Additional Requirements for POSTAL DELIVERYof ePassport and Cancelled Green Passports (within Austria)

Self-addressed envelope, stamped and registered.

(If you do not enclose an envelope, you must pay an additional EUR 6.00 for postage for Austria and EUR 15.00 for Croatia, Slovakia and Slovenia, EUR 25.00 for Germany)

Mailing address of the Philippine Embassy:

Philippinische Botschaft – Konsularabteilung

Laurenzerberg 2/II/zwg

A-1010 Wien

Account of the Philippine Embassy for Bank Transfer:

Name of Account:PHILIPPINE EMBASSY

Bank: Bank Austria Creditanstalt

Account Number:0444-58800/00

Bank Code: 12000

For international transactions:

IBAN: AT21 1100 0044 4588 0000

BIC: BKAUATWW

Please remit the payment free of charges for the recipient;

Please do not forget to indicate purpose of transaction and name/s of applicant/s.