Bi Form Cgaf-002-Rev 0

BI FORM CGAF-002-Rev 0

This document may be reproduced and is NOT FOR SALE

CONSOLIDATED GENERAL APPLICATION FORM FOR NON-IMMIGRANT VISA AND WORK PERMITS I. APPLICATION INFORMATION 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. 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.

Present Immigration Status Nature of Application Conversion Extension

Inclusion

Permit

Type of Visa/Permit Application Number of Months/Years Applied For 3 Months 1 Year 2 Years Method of Application Personal Authorized Representative

3 Years

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-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-MMM-YYYY e.g. 01 JAN 1990]

III. APPLICANT’S PERSONAL INFORMATION Last Name First/Given Name Middle Name Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]

Gender M

Citizenship/Nationality

Height [cm] Profession/Occupation Contact Number(s) in the Philippines

Country of Birth F Civil Status

Weight [kg]

Single

Married

Annulled

Separated

Widowed

Divorced

Special Security Registration Number (SSRN) Email Address

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

Barangay, Municipality/City

Province, Zip Code

Country, Zip Code

Name of Spouse Last Name, First/Given Name, Middle Name 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, use BI Form 2014-00-005 Rev 0. IV. PETITIONER’S INFORMATION Name of Institution

Registration Number Nature of Institution

Commercial Religious Registered Address in the Philippines House/Unit No., Street, Subdivision/Village Barangay, Municipality/City

Province, Zip Code

Others [Please specify]: aa_________________ ___________________ Contact Number(s) in the Philippines ___________________ Landline __________________ Mobile

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BI FORM CGAF-002-Rev 0

This document may be reproduced and is NOT FOR SALE

CONSOLIDATED GENERAL APPLICATION FORM FOR NON-IMMIGRANT VISA AND WORK PERMITS V. ACR I-CARD

Alien Certificate of Registration (ACR) Number

DO NOT FILL OUT THIS PORTION 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]

Reviewed by: ____________________________________________ Certificate of Residence Number (CRN)

_____________________

Date [DD-MMM-YYYY]

Approved by: ____________________________________________

________________________________________

____________________________ ___________

Petitioner’s Signature over Printed Name

Applicant’s Signature over Printed Name

Evaluated and Reviewed by: Recommended for:

_____________________________________

Supervising Visa Officer

Approval

(Signature over Printed Name) Date Signed: ___________________

Valid from: ______________________________ [DD-MMM-YYYY] Until: ______________________________ [DD-MMM-YYYY]

Recommending Approval:

Disapproval* * Please see attached findings.

____________________________________________

Head, Visa and Permits Task Force

(Signature over Printed Name) Date Signed: ____________________

CERTIFICATION I HEREBY CERTIFY that this application was APPROVED/DISAPPROVED by the Board of Commissioners during its meeting on ____________________________. This is to certify further that a ______________________ visa valid from _____________ to _____________ is hereby authorized to be issued to applicant.

[DD-MMM-YYYY]

[DD-MMM-YYYY]

ERIC E. DIMACULANGAN Application Number Executive Director Date Signed: ______________

“VISA IMPLEMENTATION STAMP”

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