Postal Id Application Form

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PID Form No.

Re p u b l i c o f t h e P h i l i p p i n e s
Revision (No.) (Date)
PHILIPPINE POSTAL CORPORATION Application Control No.:

APPLICATION FOR POSTAL ID CARD Accepting Post Office Code:


Accepting Post Office Name:
OR No: OR Date:
ALL FIELDS WITH ( ) ARE REQUIRED PLEASE READ THE GENERAL TERMS AND CONDITIONS AT THE BACK BEFORE ACCOMPLISHING
POSTAL REFERENCE NO. (Leave blank if New Application)
THIS FORM. PRINT ALL INFORMATION IN CAPITAL LETTERS AND USE BLACK INK ONLY.

PART I - TO BE FILLED OUT BY THE APPLICANT


A. APPLICATION TYPE
PURPOSE INITIAL CARD REPLACEMENT

NOT
Amendment of Name Amendment of Biographic Data Replacement of Damaged Card
RENEWAL
Replacement of Lost Card Amendment of Authenticating Finger Others

B. APPLICANT DETAILS
APPLICANT’S NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)

GENDER DATE OF BIRTH (MM/DD/YYYY) PLACE OF BIRTH (CITY/MUNICIPALITY) (PROVINCE) (COUNTRY)

FATHER’S NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)

MOTHER’S MAIDEN NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)

NATIONALITY OCCUPATION CIVIL STATUS


Single Married Widowed Separated Divorced/Annulled
GSIS No.(If GSIS member) SSS No.(If SSS member) TIN No.(If Available)

CRN No.(If Available) PHILHEALTH No.(If member) HDMF No.(If member)

EYES (COLOR) HAIR (NATURAL COLOR) COMPLEXION TELEPHONE NUMBER MOBILE NUMBER

FOR
DISTINGUISHING FACIAL FEATURES WEIGHT (KILOS) HEIGHT (CENTIMETERS) EMAIL ADDRESS

C. ADDRESS DETAILS
PREFERRED MAILING ADDRESS (CHOOSE ONE) PRESENT WORK
PRESENT ADDRESS
(RM/FLR/UNIT NO./ BLDG. NAME) (HOUSE/ LOT & BLK NO.) (STREET NAME)

(SUBDIVISION) (BARANGAY/DISTRICT/LOCALITY)

(CITY/MUNICIPALITY) (PROVINCE) (COUNTRY) (POST CODE)

WORK ADDRESS
EMPLOYMENT STATUS COMPANY TYPE
Contractual Regular / Permanent Household Self Employed OFW Government Private Others
(COMPANY/RM/FLR/UNIT NO./BLDG. NAME) (HOUSE / LOT & BLK NO.) (STREET NAME)

(SUBDIVISION) (BARANGAY/DISTRICT/LOCALITY)

(CITY/MUNICIPALITY) (PROVINCE) (COUNTRY) (POST CODE)

SALE
D. APPLICANT’S CERTIFICATION
N ot w it hst anding t he confi den t i a l i t y o f t he da t a t ha t I ha v e suppl i e d he re i n, I he r eby give my Fur ther, all s tatements / data on the FINGERPRINTS IF APPLICANT CANNOT SIGN:
consent t hat t he same be sec ure d a nd a c c e sse d f o r subse que nt v a l i da t i o n, v e rifi cation, and oper ator 's s cr een, which wer e s hown to me
other purposes consist ent w i t h t he o bj e c t i v e s o f t hi s c a rd e nro l l m e nt . I f urt her affi r m that at or about the time I affi xed my s ignatur e
by af fi xing my signat ure on t hi s f o rm , a l l st a t e m e nt s/da t a a ppe a ri ng i n t hi s f or m ar e tr ue, her ein, ar e tr ue, cor r ect and complete to the
correct and complet e. While a ppl y i ng f o r t hi s c a rd, I l i k e w i se f ul l y a gre e t o a nd under s tand bes t of my knowledge and belief.
all t he t erms of it s issuance a s go v e rne d by P o st a l rul e s a nd re gul a t i o ns.
Higit pa r ito, ang aking lagda s a for m na ito
Ibi nibigay ko ang aking pahi nt ul o t na ga m i t i n a ng m ga k o m pi de nsy a l na i mpor mas yong ay nagpapatunay na ang lahat ng
nakasaad sa it aas sa pagpapa t una y, pa gbe be ri pi k a a t i ba pa ng pa m a m a ra a ng kaugnay s a impor mas yong makikita s a kompyuter s cr een
pr oseso ng paggaw a ng Post a l I D . Ang a k i ng l a gda sa f o rm na i t o a y na gpa pa tibay na ang ng oper ator ay totoo, tama at kumpleto s a
lahat ng impormasyong maki k i t a sa f o rm na i t o a y t o t o o , t a m a a t k um pl e t o . N a iintidihan ko aking buong kaalaman at paniniwala.
r in at sumasang-ayon ako sa m ga a l i t unt uni n a t re gl a m e nt o na sum a sa k l a w sa pagkakar oon
ng Post al ID card. RIGHT THUMB RIGHT INDEX

APPLICANT’S SIGNATURE APPLICANT’S SIGNATURE WITNESS’ SIGNATURE

SIGNATURE OVER PRINTED NAME DATE SIGNATURE OVER PRINTED NAME DATE SIGNATURE OVER PRINTED NAME

PART II - TO BE FILLED OUT BY PHLPOST


SUPPORTING DOCUMENTS PRESENTED: APPROVED BY:
NSO Birth Certificate Barangay Certificate
Others SIGNATURE OVER PRINTED NAME DATE
DATA CAPTURE SCHEDULE DATA CAPTURED BY:
DATE
SCREENED BY: Capturing Post Office Name / Code:

SIGNATURE OVER PRINTED NAME DATE Date / Time: SIGNATURE OVER PRINTED NAME
TEAR HERE
Re p u b l i c o f t h e P h i l i p p i n e s Application Control No.:
PHILIPPINE POSTAL CORPORATION Accepting Post Office Code:

APPLICATION FOR POSTAL ID CARD AC K N OW LE D GE M E N T S L IP ( C L IENT CO PY )


Accepting Post Office Name:
OR No : OR Date:

POSTAL REFERENCE NO. (Leave blank if New Application) NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)

APPROVED BY: DATA CAPTURE SCHEDULE: DATA CAPTURED BY:


Capturing Post Office Name / Code:

SIGNATURE OVER PRINTED NAME DATE Date / Time: SIGNATURE OVER PRINTED NAME DATE
GENERAL TERMS AND CONDITIONS:
a. The Improved Postal ID is issued exclusively by PHLPost as proof of address and identity of the cardholder.

b. The card is the property of the cardholder.

c. The card is non-transferable.

d. A unique Postal Reference Number (PRN) is assigned to each cardholder.

e. The card is valid for three (3) years for Filipinos and foreign residents with Diplomatic Visa for foreign government officials/
personnel serving in foreign embassies or consulates in the Philippines, Long Stay Visitor Visa Extension, Temporary Resident Visa
and Special Resident Retiree’s Visa while one (1) year for foreign residents holding Alien Certificate Registration Identity Card and
any equivalent document allowing the applicant to stay in the Philippines for three (3) months or more issued by the Bureau of
Immigration and or Department of Foreign Affairs.

f. The cardholder is responsible for the proper use of his/her card at all times and must keep the card secure.

g. Alteration or intentional damage to the card, using another person’s card, or allowing the card to be used by another person is
not allowed and it may result in confiscation and/or termination of the card as well a legal action/s by government enforcement
agencies and PHLPost.

h. If card is lost, stolen or damaged, the cardholder must report to the Postal Payment Delivery Division, Business Lines Department
(PPSD-BLD) by SMS, email, call and/or mail within five (5) working days:

Mailing address: The Postal Payment Delivery Division Mobile No: (0917) 5215373
Business Lines Department (0998) 8847629
5/F Manila Central Post Office Bldg. (0925) 3212291
Magallanes Drive
1000 Manila, Metro Manila Website: www.phlpost.gov.ph
E-mail Address: [email protected]
[email protected]

i. The cardholder may request for replacement of the lost, stolen or damaged card to any post office, subject to compliance to the
requirements for replacement and payment of applicable fees and charges.

j. The PHLPost is not responsible for any unauthorized use of the card or for any loss arising from the failure of the cardholder to
comply with item G of this guideline.

k. If the cardholder is found to have provided false information, falsified documents or has willingly applied for a Postal ID through
fraudulent means, he/she may be subjected to legal action/s and/or sanction/s.

l. By applying for and/or using the card, the cardholder agrees to the terms of its issuance as governed by the PHLPost regulations.

m. Privacy Statement. The personal information that PHLPOST being provided is necessary to complete this application and/or
transaction. Said information will be kept confidential and secure, and shall not be used without the express consent of the data
subject..

SUBSCRIBED AND SWORN to before me this ____________, affiant exhibited to me his _________________.
Doc. No. ___;

Page No. ___;


Notary Public
Book No. ___;

Series of ___.

For Inquiries, Please Call Customer Service Service Hotline (02) 742-7349 / (02) 230-9875,
Globe - 09175215373, Smart - 09988447629, Sun - 09253212291, Mondays to Fridays from 8AM to 5PM
Visit: www.facebook.com/newpostalid, www.postalidph.com

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