Vous êtes sur la page 1sur 2

BI FORM CGAF-001-Rev 0

This document may be reproduced and is NOT FOR SALE


CONSOLIDATED GENERAL APPLICATION FORM
FOR IMMIGRANT VISA
I. APPLICATION INFORMATION
Present Immigration Status

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.

Nature of Application
Conversion

Amendment

Inclusion

Type of Visa Application


Method of Application
Personal

Authorized Representative

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

II. APPLICANTS 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. APPLICANTS 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]

Country of Birth
F
Civil Status

Weight [kg]

Profession/Occupation
Contact Number(s) in the Philippines

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. PETITIONERS INFORMATION


Last Name

First/Given Name
Middle Name
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village

Barangay, Municipality/City

Province, Zip Code

Country, Zip Code

Contact Number(s) in the Philippines


Landline

Mobile
Page 1 of 2

BI FORM CGAF-001-Rev 0
CONSOLIDATED GENERAL APPLICATION FORM
FOR IMMIGRANT VISA

This document may be reproduced and is NOT FOR SALE

V. ACR I-CARD

DO NOT FILL OUT THIS PORTION

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]

Reviewed by: ____________________________________________


Certificate of Residence Number (CRN)

_____________________

Date [DD-MMM-YYYY]

Approved by: ____________________________________________

________________________________________

_______________________________________

Petitioners Signature over Printed Name

Applicants 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

Page 2 of 2