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CGAF-001-REV 02 Consolidated General Application Form for Immigrant Visa
BI application form for immigrant visa
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CGAF-001-Rev 2
This document may be reproduced and is NOT FOR SALE
CONSOLIDATED GENERAL APPLICATION FORM
FOR IMMIGRANT VISA
I. APPLICATION INFORMATION
Present Immigration Status
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. APPLICANT’S TRAVEL INFORMATION
Passport Number
Date of Latest Arrival [DD
[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. APPLICANT’S PERSONAL INFORMATION
.
Last Name
First/Given Name
Middle Name
Other Name(s)/Alias(es)
1
2
Date of Birth [DD-MMM-YYYY e.g. 01 JAN 1990]
]
Gender
Country of Birth
M
F
Citizenship/Nationality
Civil Status
Single
Height [cm]
Weight [kg]
Married
Annulled
Separated
Widowed
Divorced
Profession/Occupation
Contact Number(s) in the Philippines
Email Address
Landline
Mobile
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village
Residential Address Abroad
House/Unit No., Street, Subdivision/Village
Barangay, Municipality/City
City, State
Province, Zip Code
Country, Zip Code
Name of Spouse [Last Name, First/Given Name, Middle Name
,
Name]
Other Name(s)/Alias(es)
1
2
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, u
use BI Form 2014-00-005 Rev 0
005
0.
APPLICANT’S ACR I
I-CARD CLAIM STUB
Applicant’s Name [Last Name, First/Given Name, Middle Name (Please leave a box after each name)]
Last
ACR Number
Visa Type
Page 1 of 2
BI FORM CGAF-001-Rev 2
CONSOLIDATED GENERAL APPLICATION FORM
FOR IMMIGRANT VISA
This document may be reproduced and is NOT FOR SALE
[IF THE ACR I-CARD IS CLAIMED BY AN AUTHORIZED REPRESENTATIVE, PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS.]
Character References in the Philippines
Last Name, First/Given Name, Middle Name
1
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village
Barangay, Municipality/City
Province, Zip Code
Contact Number(s) in the Philippines
Landline
Mobile
Last Name, First/Given Name, Middle Name
2
Residential Address in the Philippines
House/Unit No., Street, Subdivision/Village
Barangay, Municipality/City
Province, Zip Code
Contact Number(s) in the Philippines
Landline
Mobile
IV. PETITIONER’S 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
Contact Number(s) in the Philippines
Landline
Mobile
V. ACR I-Card
Alien Certificate of Registration (ACR) Number
DO NOT FILL OUT THIS PORTION
Application Number
Date of Issuance [DD-MMM-YYYYe.g. 01 JAN 1990]
Expiry Date/Valid Until [DD-MMM-YYYYe.g. 01 JAN 1990]
Received/Recommended by: ________________________________
Reviewed by: ____________________________________________
Certificate of Residence Number (CRN)
Approved by: ____________________________________________
CERTIFICATION
I/We certify that: (1) All the information in the application is truthful, complete and correct; (2) All documents
are authentic and were legally obtained from the corresponding government agencies or private entities; (3) I/We
understand that my/our application may be summarily denied if: (a) Any statement is false; (b) Any document
submitted is falsified; or (c) I/We fail to comply with all the BI requirements without prejudice to whatever action the
BI may take; and (4) I/We have not filed this or any similar application before any office of the Bureau.
____________________
______________________________________
Date [DD-MMM-YYYY
e.g. 01 JAN 1990]
Petitioner’s Signature over Printed Name
_____________________________________
Applicant’s Signature over Printed Name
ACR I-CARD WILL ONLY BE RELEASED UPON COMPLIANCE/SUBMISSION OF THE FF:
Name of Representative _________________________________
Accredited Travel Agency/Law Office _______________________
BI Accreditation No. _____________________________________
1. Photocopy of passport bio-page of the ACR I-Card holder
2. Valid ID of either parent claiming the ACR I-Card, if applicant is a minor
3.Photocopy of the BI-Accreditation ID card, if claimed by a travel agent or law firm
4.Special Power of Attorney (SPA), if claimed by an authorized representative other than the
parent or BI accredited entity
Contact No. ___________________________________________
Residential /Office Address _______________________________
Signature_____________________________________________
ACR I-Card Holder: _________________________
Signature over PRINTED NAME
Claimant:_____________________
Signature
[Please call (+632) 525-7557 to check the status of your application]Page 2 of 2
