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    VCU Form 1

    Uploaded by

    Michael Villame
    The document is a request form for certification from the Bureau of Immigration. It requests certification for an individual's name, date of birth, nationality, and other information. It specifies the type of certification being applied for, which includes BI Intelligence Clearance (pending application), Certified True Copy, and others. It provides instructions on documentary requirements and payment procedures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    VCU Form 1

    Uploaded by

    Michael Villame
    366 views2 pages
    The document is a request form for certification from the Bureau of Immigration. It requests certification for an individual's name, date of birth, nationality, and other information. It specifies the type of certification being applied for, which includes BI Intelligence Clearance (pending application), Certified True Copy, and others. It provides instructions on documentary requirements and payment procedures.

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    immigration

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    © Attribution Non-Commercial (BY-NC)

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    The document is a request form for certification from the Bureau of Immigration. It requests certification for an individual's name, date of birth, nationality, and other information. It specifies the type of certification being applied for, which includes BI Intelligence Clearance (pending application), Certified True Copy, and others. It provides instructions on documentary requirements and payment procedures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    366 views2 pages

    VCU Form 1

    Uploaded by

    Michael Villame
    The document is a request form for certification from the Bureau of Immigration. It requests certification for an individual's name, date of birth, nationality, and other information. It specifies the type of certification being applied for, which includes BI Intelligence Clearance (pending application), Certified True Copy, and others. It provides instructions on documentary requirements and payment procedures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    REQUEST FOR CERTIFICATION

    (Check the type of certfcaton you are appyng for. Pease provde the nformaton beng asked.)
    BI Intelligence Clearance Pending Application
    |No Derogatory Record| |Immgrant & Non-Immgrant Vsa|
    Certified True Copy OTHERS
    |Bureau of Immgratons Certfcates| |Pease specfy|
    ________________________

    Date: ______________, 200_
    THE COISSIONER
    THIS BUREAU
    Dear Sr/Madam :
    May I request a certfcaton for:
    SURNAME
    FIRST NAME
    MIDDLE NAME
    OTHER NAME
    Purpo!e" ______________________________________________________
    OTHER INFORATION
    SEX M F
    DATE OF BIRTH / /
    PLACE OF BIRTH
    NATIONALITY
    PHILIPPINE ADDRESS
    PASSPORT NO.
    TEL. NO./CEL. NO
    #ery truly your!$
    ______________________
    SI%NATURE of Requestng Party
    ___________________________
    PRINTE& NAE of Requestng Party
    NOTE : Please see BACK PAGE for LIST OF DOCUMENTARY REQUIREMENTS for sub!ss!o"#
    $CU For %
    Bureau of I!&ra'!o"
    $er!f!(a'!o" ) Cer'!f!(a'!o" U"!'
    C ' A I S T U B
    BI I"'ell!&e"(e Cleara"(e PENDING A**l!(a'!o" CTC +Cer'!f!e, True Co*-.
    Nae of Sub/e(' : 00000000000000000000000000000000000000000000000000000000000
    Da'e of B!r'1 : 000000000000000000 Na'!o"al!'- : 00000000000000000000000000
    FRONT PAGE
    SPECIFIC REQUIREENT! "
    Month / Day / Year
    Verification of
    DEROGATORY +2DO3BL34L.
    NAIA 1
    Verifier ________________
    Date/Time ______________
    NAIA 2
    Verifier ________________
    Date/Time ______________
    $CU For %
    THIS FORM IS NOT FOR SALE
    REPROD!"TION IS ALLO#ED
    $an% 2&&'
    DATE 3 TIME
    RECEI$ED
    $CU 5!",o5
    ((((((((((((((
    2 to ( )o*r+ ,roce++in- *,on ,a.ment /e,en/in- on t)e 0o1*me of a,,1ication
    A12a.+ ,re+ent t)i+ recei,t *,on c1aimin- .o*r certificate
    !nc1aime/ certificate +)a11 3e a*tomatica11. cance11e/ after (& /a.+ from t)e /ate of i++*ance
    If not t)e c1aimant of certificate ,re+ent an. 0a1i/ ID "ar/+
    &ATE ) TIE FI'E&"
    &ATE ) TIE relea!ed "*
    BI INTELLIGENCE CLEARANCE :
    Attac)e/ 4ERO4 "OP5 of PASSPORT
    PENDING APPLICATION :
    Attac)e/ 4ero6 co,. of a,,1ication 7+tam, recei0e/8
    CERTIFIFIED TRUE COPY :
    Procee/ to Room (&1 (
    r/
    F1oor at Recor/+ Section
    CERTIFICATION FEE+S "
    "ertification 9&&%&&
    Le-a1 Re+earc) 1&%&&
    E6,re++ Fee 9&&%&&
    T O T A L P1 P %67%7#77
    "o11ecte/ *n/er "%A% No% :1(
    Section ;27A871<8
    #it) MEMORANDUM ORDER NO# 7897:; /ate/ 8< Se*'eber 8778
    FOR PEN&IN% APP'ICATION ON',
    PENDING APPLICATION= _________________
    Si-nat*re = _________________
    Printe/ Name= _________________
    Office = _________________
    Date = _________________
    >A"? PAGE
    PROCEDURE:
    A,,1icant+ +)o*1/ 0erif. 2it) t)eir a++i-ne/ >ID La2.er+ an/ fi11 *, t)e a3o0e ,ortion% A''a(1 a *1o'o(o*- of '1e
    *e",!"& a**l!(a'!o"#
    After accom,1i+)in- t)i+ form t)e a,,1icant +)o*1/ +ec*re an Or/er Pa.ment S1i, @OPSA an/ ,a. t)e amo*nt at t)e
    "a+)ier% After ,a.ment ,re+ent t)e Officia1 Recei,t @ORA to-et)er 2it) t)i+ form at t)e Verification B "ertification !nit in
    or/er to ,roce++ t)e "ertification%

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