(FOR CFO USE ONLY)
CFO No. / Emigrant No.
OR #
GCC Form #
Issue Date [ mm-dd-yyyy ]
Category
Reg. Date [ mm-dd-yyyy ]
Verifier
Last Name Suffix
First Name
Middle Name
If married, please state mother's maiden name
DATE OF BIRTH [ mm-dd-yyyy ] AGE SEX CIVIL STATUS
PLACE OF BIRTH
Outside of the Philippines
Town / City
Province
ADDRESS & CONTACT NUMBERS IN THE PHILIPPINES
House No. / Street / Barangay
Town / City
Province Zip Code
Telephone Number Cellphone Number
E-mail Address
ADDRESS & CONTACT NUMBERS (Country of Destination)
House No. / Street
City / State
Country Zip Code
Telephone Number Cellphone Number
PASSPORT NUMBER DATE OF ISSUE [ mm-dd-yyyy ]
VISA NUMBER DATE OF ISSUE [ mm-dd-yyyy ]
Revised as of January 2008 THIS FORM IS NOT FOR SALE
PERSONAL DATA
COMMISSION ON FILIPINOS OVERSEAS
INFORMATION SHEET FOR FILIPINO EMIGRANTS
Please PRINT letters in the spaces provided.
Please CHECK () appropriate box(es).
Divorced Widow(er) Separated
INSTRUCTIONS :
Male Female
Single Married
PHOTO
HIGHEST EDUCATIONAL ATTAINMENT
Elementary Level Vocational Level Post Graduate Level Not of schooling age
Elementary Graduate Vocational Graduate Post Graduate ( Below 7 yrs old )
High School Level College Level No Formal Education
High School Graduate College Graduate Others
If vocational / college / post graduate, state course
ECONOMIC STATUS
Employed Self-employed Unemployed
If employed / self-employed, state profession / occupation / business
If unemployed, check appropriate box
Housewife Student Retiree Out-of-school youth Minor (Below 7 yrs old) Not reporting any occupation
DATA OF NEAREST FAMILY MEMBER IN THE PHILIPPINES
Last Name Suffix
First Name
Middle Name Relationship
House No. / Street / Barangay
Town / City
Province Zip Code
Telephone Number Cellphone Number E-mail Address
Last Name Suffix
First Name
Middle Name Relationship Age
ADDRESS & CONTACT NUMBERS ABROAD
House No. / Street
City / State
Country
Zip Code E-mail Address
Telephone Number Cellphone Number
CITIZENSHIP YEAR OF MIGRATION [ yyyy ]
OCCUPATION
Revised as of January 2008 THIS FORM IS NOT FOR SALE
SIGNATURE ABOVE PRINTED NAME
CERTIFICATION
PETITIONER'S DATA
I hereby certify under penalty of law to the truth and correctness of
the statement and that this form was accomplished by me
personally or under my personal direction.