Petition for Inclusion of Dependent(s)

BI form for petition for inclusion of dependent(s) for dual citizenship

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This document may be reproduced and is NOT FOR SALE

UNDER R.A. 9225

I, ____________________________________________________________________________,
[Full name of Petitioneras appearing in the Dependent’s Birth Certificate]

_____ years of age, a citizen of _____________________________________ and a resident of
______________________________________with contact number _________________, after being
sworn to in accordance with law, hereby declare under oath that:
1. I petition for the Inclusion of my dependent for Re-acquisition/ Retention of Philippine Citizenship
under Republic Act No. 9225, namely;
Name :________________________________________________________________________
[as appearing in Birth Certificate]

Also known as:__________________________________________________________________
[as appearing in foreign passport]

Date of Birth: ______________________ Age:___________ Gender:_______________________
Place of Birth: _____________________________________ Civil Status: ___________________
Nationality: ______________________________ Valid Passport No.:_______________________
Date of Issuance: _________________________ Place of Issuance:________________________
Father’s Name: __________________________________________________________________
Mother’s Name: _________________________________________________________________
2. I took my Oath of Allegiance to the Republic of the Philippines on ___________________________
at ___________________. My petition was approved on _____________________ and I was
issued Certificate no. _____________________;
3. I surrender for cancellation his/her certificate of Alien Certificate of Registration (ACR) No.
___________________ and Immigrant Certificate of Residence/ Certificate of Residence for
Temporary Visitors (ICR/CRTV) No. ____________________.
WHEREFORE, it is prayed that this petition for Reacquisition and/or Retention of Philippine Citizenship
under Republic Act No. 9225 be GRANTED.

Attach your 2x2 colored photograph
with 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.

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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