9e Visa Extension Application Form DFA-OCA

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DEPARTMENT OF FOREGN AFFAIRS DFA-OCA-Visa-03-Rev.

00/Sept18
Office of Consular Affairs

APPLICATION FOR 9(e) VISA EXTENSION

Please provide requested information. Answers must be in English, legibly in BLOCK LETTERS.
I. GENERAL INFORMATION
1.) Name of Embassy/Mission or International Organization

Affix recent
2.) Official Designation 2a.) Diplomatic ID No. passport-size
colored photo
II. PERSONAL INFORMATION (as appearing in diplomatic/service/special passport/UNLP) here
3.) Name (Surname, Given Name, Middle Initial)
DO NOT
STAPLE
4.) Date of Birth (DD-MM-YYYY) 5.) Age 6.) Sex (M, F, X) 7.) Citizenship

8.) Place of Birth 9.) Civil Status Single Married Widow/er


Divorced Living with Partner/Common Law Spouse
9a.) Name of Spouse/Partner 10.) If applicant is dependent/member of household
Name of Principal:
Designation:
Relationship:
III. PASSPORT INFORMATION/VALID TRAVEL DOCUMENT
11.) Passport No. 12.) Type 13.) Date of Issue 14.) Expiry Date

IV. ASSIGNMENT/POSTING DETAILS


15.) Date of Arrival in the 16.) Expected End of Duration of 17.) Date of Most Recent Arrival in
Philippines to join Principal/for Tour of Duty (dd/mm/yyyy) the Philippines (dd/mm/yyyy)
Assignment (dd/mm/yyyy)

V. CURRENT VISA INFORMATION


18.) Control No. 19.) Date of Expiry 20.) Issuing Authority

DECLARATION : I attest that the foregoing information that I have provided is true
and accurate to the best of my knowledge.

Date Accomplished:
_______________________________________
__________________ Signature Above Printed Name of Visa Applicant

----------DO NOT FILL BELOW THIS LINE (for DFA use only) -----------

Control No.: Sticker No.:


Visa type:
Remarks: _____________________
Signature of Authorizing Official

Date Initial
Received
Processed
Issued in accordance with CA613/PA1940, as amended, and pursuant to Sec. 86, 2002 CVRR Signed
Released

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