Foreign Service fo the Philippines Philippine Embassy in Wellington, NZ APPLICATION FOR NON-IMMIGRANT VISA TO THE PHILIPPINES TYPE OR PRINT IN BLOCK LETTERS LEGIBLY. PLEASE COMPLETE ALL ENTRIES TO AVOID DELAY. Surname First Name
Place of Birth Date of Birth(MM/DD/YR) Age Citizenship Sex
Male Female Applicant's Address Telephone No.
Occupation Office of Employment and Address Telephone No.
Father's Name Mother's Name
Civil Status If Married name of Spouse Citizenship Single Separated Name and ages of Children, if any Married Divorce/ Name and address of sponsor/reference in the Philippines Tel No. Widowed Annulled Passport/Travel Document no. Date of Issue Valid until Issued by
Arrival Date in the Philippines Length of stay Port of Entry Purpose of Entry
Name of travelling companion (for minor applicant) Destination after the Philippines
Have you ever been issued a Philippine visa? Yes No
Latest visa no. ______________ Type of visa ______________ Issued on ________ Issued by _________ Latest Entry Date _____________ Latest Exit Date ___________ Duration of last stay in the Philippines ________ Documents submitted in support of application Valid passport/travel document Chinese ID No. Affidavit of support & guarantee Household Registry Air Ticket (for travel agency only) Financial proof Others (specify)_____________ Invitation letter 1. Were you ever refused any kind of Philippine visa before and denied into or deported from the Philippines? Yes No If yes, state circumstances _________________________________ 2. Have you ever been arrested or convicted for any offense or crime, even through subject of a pardon, amnesty, or other legal action? Yes No If yes, state circumstances ______________________ _________________________________________________________________. 3. Have you ever been afflicted with a communicable disease of public health significance, dangerous physical or mental disorder, or been a drug abuser or addict? Yes No If yes, state circumstances _________________________________________________________________. I understand that I may only enter the Philippines at the Port of Entry designated by the Philippine Immigration Authorities and under the condition imposed by those authorities. I solemnly swear that the foregoing statements are true to best of my knowledge. Warning: (1) Drug trafficking is punishable under Philippine law. (2) Tourist are not allowed to engage in any pedding activity. _____________________________________ Violators will be subject to deportation. APPLICANT'S SIGNATURE/DATE _________________________________________________________________________________________________ SUBSCRIBED AND SWORN to before me this (day)______________________.
JUSTICE OF THE PEACE
_________________________________________________________________________________________________ DO NOT FILL OUT BELOW THIS LINE (FOR OFFICIAL USE ONLY) Visa No. Granted on: As Non-Immigrant Under Sec. 9(a,c,e),13 (a,g) of the Philippine Immigration Act of 1940, as amended: Valid Until: Consul of the Republic of the Philippines Processed & Verified by: SN# Fee: NZ$ OR#