Appendi x
AnnexB
Republ i kangPi l i pi nas KAGAWARAN NG KATARUNGAN Depar t mentofJ ust i ce Mani l a APPLI CATI ON FOR I SSUANCEOFVI SAS,OR FOR CHANGEOFADMI SSI ON STATUS,TO,OR FOR EXTENSI ON OFSTAYAS,SPECI ALNONI MMI GRANTUNDER SECTI ON 47( A) ( 2)OFTHEPHI LI PPI NEI MMI GRATI ON ACTOF 1940,AS AMENDED. Theunder si gned,f orandi nbehal foft hef or ei gnnat i onalnamedbel ow,her ebyappl i esf orhi s/ her admi ssi onas/ changeofadmi ssi onst at ust o/ ext ensi onofhi s/ herst ay ,asspeci alnoni mmi gr antunderSect i on 47( a) ( 2)oft hePhi l i ppi neI mmi gr at i onActof1940,asamended,andi nsuppor tt her eofsubmi t st hef ol l owi ng i nf or mat i onandr epr esent at i on. . I . 1)NameofAppl i cant / Sponsor :__________________________________ a)
Addr ess:_____________________Tel .No:_________________
b) Nat ur eofBusi nessEmpl oymentorAct i vi t y: _____________________________________________________ 2)NameofFor ei gnNat i onal :___________________________________ a)Dat eofBi r t h:__________________Pl aceofBi r t h:____________ b)Sex:_______Age:____________Ci vi lSt at us:_______________ c)
Nat i onal i t y:_________________Passpor tNo:________________
d)
Posi t i on/ Nat ur eofEmpl oyment : ___________________________
e)
I fmar r i ed:
NameofSpouse:______________________Age:____________ Name/ sofChi l dr en:_____________________ _____________________________________Age:____________ _____________________________________Age:____________ _____________________________________Age:____________
f )
Wi l lt hespouseandunmar r i edmi norchi l dr enj oi nt heFor ei gnNat i onal ?
( ) No
( ) Yes
When?________________________
3)For ei gnNat i onal ’ spr evi ousr esi dencef ort hepastf i ve( 5)year s: __________________________________________________________ __________________________________________________________
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