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FOI Request Form

PPA request form for freedom of information

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CONTACT US
Tel Nos.:
PPA Head Office Building, A.Bonifacio Drive.,
South Harbor, Port Area, Manila

Fax No.:
Email:
Website:

(02) 527-6423 /
(02) 527-8356 local 702
(02) 527-4747
foi1@ppa.com.ph
www.ppa.com.ph

ACCESS TO INFORMATION REQUEST FORM
To be accomplished by the Applicant
1. Name :
2. Residence/Business
Address

House No./Blk. No.

Street

Barangay

Mobile No.:

Valid Email:

City/Municipality

3. Proof of Identity:
4. Contact Information

Landline:

5. Detailed description of the information/document requested:

6. Purpose of the request:

7. Name and signature of authorized representative if any:

Proof of identity and/or evidence of authority:

CERTIFICATION UNDER OATH
I hereby certify under oath that the undersigned is the person whose name and signature appears
here and that the above-requested information will be used for the stated purpose/s and for no other.
None of the contents of such document/information will be disclosed to a third party, except the
applicant here. I have not misused any information previously obtained from this Office. In case where
a study is conducted in line with a school-sanctioned project, the identity of the concerned public
officer/s or employee/s shall not be unduly disclosed but shall be referred in general terms (e.g. mayors
of Metro Manila) to prevent unnecessary disclosure of information about the public official/s or
employee/s. Should I violate the terms of this undertaking, I understand that I will be proceeded
against under the Revised Penal Code for perjury.

Signature over printed name
 
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