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FA FORM No 2 (Revised 2000): APPLICATION FOR NON IMMIGRANT VISA CONSULATE GENERAL, REPUBLIC OF THE PHILIPPINES “SPIC HOUSE”



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FA FORM No.2 (Revised 2000):APPLICATION FOR

NON IMMIGRANT VISA

CONSULATE GENERAL,

REPUBLIC OF THE PHILIPPINES

"SPIC HOUSE"

88, MOUNT ROAD, GUINDY,

CHENNAI-600032.

Surname_______________________________Given Name ________________________________ Middle Name________________________________ Nationality _________________________________ Date of Birth _____/________/_______ Age ___________ [ ] Male [ ] Female

Date Month Year

Type of Passport or Travel Document

[ ] Ordinary [ ] Official [ ] Diplomatic[ ] Travel Document Passport Number ____________________________ Place of Issue_____________________________ Date of Issue ___________________________ Valid until_______________________________ Name of Applicant's Father _________________________________________________________ Name of Applicant's Mother_________________________________________________________ Name of Travelling Companion______________________________Relation__________________ (only for Applicant under 16 years old) Home Address of Applicant________________________________________________________________ Since _______________ Telephone No. _____________________Mobile No _____________________ Civil Status [ ] Single [ ] Married [ ] Widowed [ ] Separated[ ] Divorced Name of Spouse ________________________________ Date of Birth _________________ Age ____ (Date / Month / Year) Name of Child (1) _______________________________ ______________________ Name of Child (2) ____________________________________ ______________________ Name of Child (3) ____________________________________ __________________ ____ Name of Company ______________________________________________________________________ Office Address _________________________________________________________________________ Designation _______________________Telephone No. ________________ FaxNo.______________

Applicant's Signed

Photograph (passport

size) taken within the last six months. Do not attach scanned pictures.

Please affix signature on

the front side of picture.

For Official Useonly

Visa No : ________________

Section : ________________

.. 2 ..

Flight Details

Arrival in the Philippines _____ /______ / _____ Departure from the Philippines _____ /______ / ______

Date Month YearDate Month Year

Flight Number (arrivalin Philippines) ____________Flight Number (Departure from Philippines)______ Philippine Port of Entry _______________________ Numberof days in the Philippines __________

Purpose of Entry (Please tick one)

[ ] Tourism (to include short visit to family or friends)

[ ] Business (refers to participation in conference, seminar or short course orattendance to business meeting)

[ ] To work or be employed [ ] With approved authority for a working visa already sent to the Philippine Embassy / Consulate [ ] With working visa application stillbeing processed [ ] To join family member residing in the Philippines [ ] With approved authority for a dependent's visa sent to the Philippine Embassy / Consulate [ ] With dependent's visa application stillbeing processed [ ] To board ship ( for Seaman ) [ ] Special Treaty Trader or Investor / Special Resident Investor [ ] Government Official or dependent to visit on official travel [ ] To study [ ] To join Filipino spouse [ ] Foreign Volunteer [ ] Others: Please specify _______________________________________________________________ Numberof Entries Applied for : [ ] Singleentry[ ] 6 months Multipleentry [ ] 1 yr Multiple entry Other persons travelling with applicant under the same passport or travel document:

1. ______________________________________ 2. ________________________________

Applicant's Addressin the Philippines

Name of Hotel / Residence Address_________________________________________________________ Telephone Number ___________________________ Places to visit:___________________________

Reference in Philippines

Company Sponsor________________________________________________________________________ Contact Person _________________________________ContactNumber___________________________

Reference in India

Contact Person ________________________________Contact Number____________________________ Address ________________________________________________________________________________ .. 3 ..

Have you been convicted of any crime?

[ ] No [ ] Yes Please provide details _____________________________________________

Have you been issued Philippine Visa before ?

[ ] No [ ] Yes Latest Visa Number issued _____________________ Date of Issue ___________ Do you have any communicable disease? [ ] No [ ] Yes Please provide details ________________ Do you have a history of mental illness? [ ] No [ ] Yes Please provide details________________ Were you ever refused of any kind Philippine visa, denied admission into or deported from Philippine and removed at government expenses fromthe Philippines and other countries [ ] No [ ] Yes . Please provide circumstance_______________________________________ For these applying for a Philippine visa through a travel agent or representative: Name of Travel Agent/Representative : _____________________________________________________________ Contact details ________________________________________________________________________________ I understand that any false or misleading statement will result in the refusal of a visa. I understand that the possession of a visa does not automatically entitle the bearer to enter the Philippines upon arrival at any port or entry if he or she is foundinadmissible. I understand that I may enter the Philippines at the port of entry designated by the Philippine Immigration Authorities and under the conditions imposed by those Authorities.

I understand that I may be required to submit documents in addition to those submitted in the List of

Submission of Required Documents.

I understand that since my application will go through the visa processing procedure, the processing visa fee that I will pay not be refunded even if no visa is issued to me.

I certify that I have read and understood all the questions in this application form and the answers I

have furnished on this form are true and correct to the best of my knowledge and belief. Should there

be any discrepancy in the date in the application form and other related documents, the Consular Section

may not approve my application for a Philippine visa. (If applicant did not fill up the form) Name of the Person who filled up the form:_______________________Relation to applicant ____________

D A T ESIGNATURE OF APPLICANT

SUBSCRIBEDSWORN to beforemethis _______________ day of ______________________________ (Seal)Consul of the Republic of the Philippines ( For Official Use only) NonImmigrant Visa No. _______________________________ Under Section ______________________ of the Philippine Immigration Act 1940, as amended issued to _______________________________ on ______________________________ and Valid upto _________________________ Remarks, if any_________________________________________________________________________ ________________________________ Service No :______________ O.R. No:___________________________ Fee Paid: __________________quotesdbs_dbs20.pdfusesText_26