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Petition for Re-acquisition/Retention of Philippine Citizenship
BI form for petition for re-acquisition/retention of Philippine citizenship under R.A. 9225
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: BI FORM 2014-01-005 Rev 0
This document may be reproduced and is NOT FOR SALE
PETITION FORM FOR RETENTION/RE-ACQUISITION OF
PHILIPPINE CITIZENSHIP UNDER R.A. 9225
PETITION
I, ____________________________________________________________________________,
[Name in Philippine Document]
also known as _______________________________________________________, _____ years of age,
[Name in foreign passport]
male/female, am single/widowed/divorced/annulled/separated/married to _________________________
(underline applicable)
____________________________. I, a citizen of _________________and resident of _______________
____________________________________________ with contact number ______________________,
after being sworn to in accordance with law, hereby declare under oath that:
1. I am a former natural-born Philippine citizen, born on ___________________________________
[DD-MMM-YYYY e.g. 01 JAN 1990]
at ___________________________to _______________________________________________,
[Father’s name]
[as appearing in Philippine document]
_______________________________citizen by birth/election/marriage/naturalization, who was
[Father’s citizenship at the time of petitioner’s] birth
[at the time of the petitioner’s birth(underline applicable)]
married/not married to ___________________________________________________________,
[Mother’s name]
_____________________________citizen by birth/election/marriage/naturalization;
[Mother’s citizenship at the time of petitioner’s birth]
[at the time of petitioner’s birth (underline applicable)]
2. I lost my Philippine citizenship when I became a citizen of ________________________________
on _____________________. Presently, I am a holder of a valid ___________________ passport
with number _________________ issued on ___________________ at ____________________;
[DD-MMM-YYYY e.g. 01 JAN 1990]
3. I took my Oath of Allegiance to the Republic of the Philippines on __________________________
[DD-MMM-YYYY e.g. 01 JAN 1990]
at _______________________________;
(If the petitioner is a registered alien with the Bureau of Immigration):
4. I surrender for cancellation my original
Alien Certificate of Registration (ACR)
no. _______________________and/or Immigrant Certificate of Residence/Certificate of Residence
for Temporary Visitors (ICR/CRTV) no. _________________________;
(If with Dependent/s):
5. Included in this petition is/are my unmarried child/ren below eighteen (18) years of age, namely:
Name
Gender
_______________________________________
_______
_______________________________________
_______
_______________________________________
_______
(Please use BI Form 2014-01-006 Rev 0 for each dependent to
WHEREFORE, it is prayed that this petition for
Retention and/or Re-acquisition of Philippine
Citizenship under Republic Act No. 9225 be
GRANTED.
Date of Birth
Age
________________________
________________________
________________________
be attached to this petition.)
_____
_____
_____
[DD-MMM-YYYY e.g. 01 JAN 1990]
Attach your 2x2 colored
photographwith white
background using
permanent glue in the
photograph box.
The photograph must be taken
within the last three (3) months
from the date of application.
____________________________________________________
Signature over Printed Name
__________________________________________
Date [DD-MMM-YYYY e.g. 01 JAN 1990]
A scanned photograph is not
allowed. A photograph of the
applicant wearing eyewear (i.e.
sunglasses, colored contact lenses,
etc.) or headwear is not acceptable.
VERIFICATION
I certify under oath that the above statements are true and correct to my own personal knowledge, and based on authentic
documents in my possession.
________________________________________
Applicant’s Signature over Printed Name
SUBSCRIBED AND SWORN TO before me this ______________ in _______________________, Petitioner personally
appeared and exhibited to me his/her passport with number _____________________ issued on ____________________________
at __________________.
Doc No.: _________
Page No.: ________
Book No.: ________
Series of ________
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