PMNCR-03.01-F.

02
Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
NATIONAL CAPITAL REGION
G/F DOLE NCR Bldg., Maligaya St., Malate, Manila
2X2
Picture
ALIEN EMPLOYMENT PERMIT (AEP) APPLICATION FORM in white background

(Please provide all the required information and affix required signature/s. Any
misrepresentation/s, false statement/s or fraud in this application or in any supporting
document/s is a ground for denial/ revocation/cancellation of the permit.)

TYPE OF APPLICATION: [ ] NEW [ ] RENEWAL

PERSONAL DATA
NAME: _____________________________________________________________________________________
(Last name) (First name) (Middle name)
SEX:________ CITIZENSHIP:____________________
CITIZENSHIP:__________________________________ TIN: ____________________________
CIVIL STATUS DATE OF BIRTH PLACE OF BIRTH _________________________
HIGHEST EDUCATIONAL ATTAINMENT/COURSE/COURSE FINISHED:
FINISHED ________________________________________
ADDRESS IN THE PHILS. ____________________________________________________________________
_______________________________ _________________________________
_________________________________________________________
_______________________________ E-MAIL __________________________
PERMANENT ADDRESS ABROAD _____________________________________________________
______________________________________________________________
________________________________________________________________________
___________________________________________________________________________________________
___________________
PASSPORT NO._________________________ PASSPORT VALID UNTIL ____________________
______________________________
PLACE OF ISSUE________________________DATE OF ISSUE____________________________
ISSUE_______________________________________
VISA __________________________________ VALID UNTIL ______________________________
_________________________________________

EMPLOYMENT HISTORY IN THE PHILIPPINES: (Please attach additional sheet if necessary)

EMPLOYERS BUSINESS NAME AND ADDRESS POSITION DURATION OF EMPLOYMENT

PRESENT EMPLOYMENT:

POSITION _________________________________________________________________________
__________________________________________________________________________________
NATURE OF ASSIGNMENT: [ ] INVESTOR, [ ] INTRA-CORPORATE
INTRA CORPORATE TRANSFEREE, [ ] SERVICE SELLER,
[ ] PROFESSIONAL, [ ] CONTRACTU
CONTRACTUAL
AL SERVICE SUPPLIER, [ ] SPECIALIST
PLACE/S OF ASSIGNMENT ___________________________________________________________
____________________________________________________________________
NAME AND ADDRESS OF EMPLOYER __________________________________________________
___________________________________________________________
___________________________________________________________________________________
E-MAIL
MAIL ADDRESS____________________________TEL..___________________________________
ADDRESS____________________________TEL..____________________________________________
NATURE OF BUSINESS __________________________________________________________
_______________________________________________________________________
TOTAL EMPLOYMENT (Exclude Foreign Nationals) _______ NUMBER OF FOREIGN NATIONALS __________

Have your application for AEP been previously denied? [ ] yes [ ] no When? __________________
Have your AEP been previously cancelled/rev
cancelled/revoked?
oked? [ ] yes [ ] no When? __________________
Please state reason for denial/cancellation/revocation:________________________________________
___________________________________________________________________________________
What actions have
ave you taken? __________________________________________________________

___________________________________ ______________________________
SIGNATURE OF APPLICANT DATE FILED

INDORSEMENT BY THE EMPLOYER:

______________________________________
__________________________________________ _________________________________

NAME AND SIGNATURE OF COMPANY OFFICER POSITION IN THE COMPANY