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Birth Certificate Application Form Philippines

This document is an application form for requesting a birth certificate from the National Statistics Office of the Philippines. It requests information such as the owner and requester's personal details, purpose of the request, and relationship of the requester to the owner. It notes that authorization from the owner is required if the requester is not the owner, parent, spouse, descendant, or legal guardian. The form collects details needed to process and release the birth certificate in accordance with Philippine law.

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theia28
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© © All Rights Reserved
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151 views2 pages

Birth Certificate Application Form Philippines

This document is an application form for requesting a birth certificate from the National Statistics Office of the Philippines. It requests information such as the owner and requester's personal details, purpose of the request, and relationship of the requester to the owner. It notes that authorization from the owner is required if the requester is not the owner, parent, spouse, descendant, or legal guardian. The form collects details needed to process and release the birth certificate in accordance with Philippine law.

Uploaded by

theia28
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

THIS FORM IS NOT FOR SALE

Republic of the Philippines


National Statistics Office
OFFICE OF THE CIVIL REGISTRAR GENERAL

APPLICATION FORM - BIRTH CERTIFICATE


IMPORTANT : PLEASE READ GENERAL INSTRUCTIONS BEFORE FILLING UP THE FORM
General
1. Please PRINT letters in the spaces provided. Please CHECK (a) appropriate box(es).
Instructions : 2. A valid ID is required for both owner & requester of document.
Instructions: 3. An authorization is required from representative's upon filing of the application.
Request for :

BIRTH CERTIFICATE

Number of copies ?

One

AUTHENTICATION
Two

Others (Specify)

Birth Reference No.

BIRTH CARD
: __________

BReN (if known)

OWNER'S PERSONAL INFORMATION (For married women, please use maiden name)
Last Name
First Name
Middle Name
Date of Birth
MONTH

DAY

Place of Birth
City / Municipality

Province
Please specify country if
born abroad only:

Country

NAME OF FATHER
Last Name
First Name
Middle Name

MAIDEN NAME OF MOTHER


Last Name
First Name
Middle Name
REGISTERED LATE?

Check (a) appropriate box

No

Requester's
Tax Identification No.(TIN)

Yes

When:

(if known)

PLEASE TURN TO BACK PAGE


FOR NSO USE ONLY

TRANSACTION NUMBER :

CDLI

YEAR

Sex: Male
Female

PURPOSE : Choose one and check (a) appropriate box


Claim Benefits / Loans

Employment (Local)

School Requirement

Passport / Travel

(Specify Country:

Employment (abroad)

(Specify Country: _______________ )

Others (Specify) :
_____________________

REQUESTER'S INFORMATION
Last Name

, First Name

,MI

Mailing Address
House No.

Street Name / Barangay

City / Municipality
Province
Tel. No.
NOTE : AUTHORIZATION and ID of the document owner together with requester's ID are required if the
requester is NOT any of the following :
a. the owner of the document;
d. his/her direct descendant;
b. his/her parent;
e. his/her legal guardian/institution-in-charge, if minor;
c. his/her spouse;
I understand that as per PD 603 (Child & Youth Welfare Code),birth certificate documents,if available in this
office cannot be released to me without proper authorization from the owner of the document, his/her parent
(if minor), his/her spouse, his/her direct descendant, or his/her authorized guardian/institution-in-charge.
_____________________________
Signature of Applicant

FOR NSO USE ONLY

Converted ?
MONTH

DAY

YEAR

For CDLI request only:


Date of Filing

20

Date of Release

20

Remarks :

Received by

CDLI type : _______________________


Proper

: _________ pages

Attachment : _________ pages

: _____________________________________ Date of receipt : ____________________

THIS FORM IS NOT FOR SALE

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