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CGAF-002-Rev 3 Consolidated General Application form for Non-Immigrant Visa, Special Work Permit and Provisional Work Permit

BI application form for non 0 immigrant visa, special work permit and provisional work permit except for student visa and special study permit

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CGAF-002-Rev 3

This document may be reproduced and is NOT FOR SALE

CONSOLIDATED GENERAL APPLICATION FORM
FOR NON-IMMIGRANT VISA, SPECIAL WORK PERMIT AND
IMMIGRANT
PROVISIONAL WORK PERMIT [EXCEPT STUDENT VISA AND SSP]
I. APPLICATION INFORMATION
Present Immigration Status
Nature of Application
Conversion
Extension
Type of Visa/Permit Application

Inclusion

Number of Months/Years Applied For
3 Months
1 Year
Method of Application

2 Years

Personal

Permit

3 Years

Authorized Representative

BI Accreditation Number

Name of Authorized Representative [Last Name, First/Given Name, Middle Name]

Position in the Company/Institution

II. APPLICANT’S TRAVEL INFORMATION
Passport Number

Date of Latest Arrival [DD
[DD-MMM-YYYY e.g. 01 JAN 1990]

Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990]

Flight Number

Place of Issuance

Last Day of Authorized Stay [DD
[DD-MMM-YYYY e.g. 01 JAN 1990]

III. APPLICANT’S PERSONAL INFORMATION
Last Name
First/Given Name
Middle Name
Other Name(s)/Alias(es)
1
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
]

Gender

Country of Birth
M

Citizenship/Nationality

F
Civil Status
Single

Height [cm]

Weight [kg]

Married

Annulled

Separated

Widowed

Divorced

Profession/Occupation
Contact Number(s) in the Philippines

Email Address

Landline
Mobile
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village

Residential Address Abroad
House/Unit No., Street, Subdivision/Village

Barangay, Municipality/City

City, State

Province, Zip Code

Country, Zip Code

Name of Spouse [Last Name, First/Given Name, Middle Name]
,
Other Name(s)/Alias(es)
1
2
Name(s) of Child(ren) and Date(s) of Birth [Last Name, First/Given Name, Middle Name]
1
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
Last Name, First/Given Name, Middle Name
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]

Note: If the applicant has more than two (2) children, u
use BI Form 2014-00-005 Rev 0

APPLICANT’S ACR I
I-CARD CLAIM STUB
Applicant’s Name [Last Name, First/Given Name, Middle Name (Please leave a box after each name)]
Last

ACR Number

Visa Type

[IF THE ACR I-CARD IS CLAIMED BY AN AUTHORIZED REPRESENTATIVE, PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS.]
CARD
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BI FORM CGAF-002-Rev 3

This document may be reproduced and is NOT FOR SALE

CONSOLIDATED GENERAL APPLICATION FORM
FOR NON-IMMIGRANT VISA, SPECIAL WORK PERMIT AND
PROVISIONAL WORK PERMIT [EXCEPT STUDENT VISA AND SSP]
Character References in the Philippines
Last Name, First/Given Name, Middle Name
1
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village

Contact Number(s) in the Philippines
Landline

Barangay, Municipality/City
Mobile
Province, Zip Code
Last Name, First/Given Name, Middle Name
2
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village

Contact Number(s) in the Philippines
Landline

Barangay, Municipality/City
Mobile

Province, Zip Code
IV. PETITIONER’S INFORMATION
Name of Institution

Registration Number
Nature of Institution
Commercial

Religious

Others [Please specify] ____________________________________________________________

Registered Address in the Philippines
House/Unit No., Street, Subdivision/Village

Contact Number(s) in the Philippines
Landline

Barangay, Municipality/City
Mobile

Province, Zip Code
V. APPLICANT’S OTHER INFORMATION
Position in the Organization

Expiration of Contract [DD-MMM-YYYY e.g. 01 JAN 1990]

Alien Employment Permit (AEP) Number

Actual Monthly Gross Salary in Philippine Currency

AEP Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990]

DO NOT FILL OUT THIS PORTION
VI. ACR I-Card
Alien Certificate of Registration (ACR) Number

Application Number

Date of Issuance [DD-MMM-YYYY e.g. 01 JAN 1990]

Received/Recommended by: _______________________________
Expiry Date/Valid Until [DD-MMM-YYYY e.g. 01 JAN 1990]
Certificate of Residence Number (CRN)

Reviewed by: ___________________________________________
Approved by: ___________________________________________

CERTIFICATION
I/We certify that: (1) All the information in the application is truthful, complete and correct; (2) All documents
are authentic and were legally obtained from the corresponding government agencies or private entities; (3) I/We
understand that my/our application may be summarily denied if: (a) Any statement is false; (b) Any document
submitted is falsified; or (c) I/We fail to comply with all the BI requirements without prejudice to whatever action the
BI may take; and (4) I/We have not filed this or any similar application before any office of the Bureau.

____________________

______________________________________

Date [DD-MMM-YYYY
e.g. 01 JAN 1990]

Petitioner’s Signature over Printed Name

_____________________________________

Applicant’s Signature over Printed Name

ACR I-CARD WILL ONLY BE RELEASED UPON COMPLIANCE/SUBMISSION OF THE FF:
Name of Representative _________________________________
Accredited Travel Agency/Law Office _______________________
BI Accreditation No. _____________________________________

1. Photocopy of passport bio-page of the ACR I-Card holder
2. Valid ID of either parent claiming the ACR I-Card, if applicant is a minor
3.Photocopy of the BI-Accreditation ID card, if claimed by a travel agent or law firm
4.Special Power of Attorney (SPA), if claimed by an authorized representative other than the
parent or BI accredited entity

Contact No. ___________________________________________
Residential /Office Address _______________________________
Signature_____________________________________________

ACR I-Card Holder: _________________________
Signature over PRINTED NAME

Claimant:_____________________
Signature

[Please call (+632) 525-7557 to check the status of your application]

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