Dual Citizenship Appointment Request Form - New York, Pcg
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1To be filled-out by the
DUAL CITIZENSHIP APPOINTMENT REQUEST FORM
Consulate General:
Thank you for electing to submit your documents for pre-processing, as this facilitates:
IC No:________________
Reduced waiting time;
•
Date:_________________
Early-screening so we can advise you in case additional documents are required;
•
Consultation and advise, to see if indeed Dual Citizenship is the correct process, or if you may be better-served by
•
other procedures.
PLEASE ACCOMPLISH THE FOLLOWING INFORMATION
(one request form per applicant)
Full Name of Applicant: _____________________ _______________________
______________________
Last Name
First Name
Middle Name
For Married Women:
Full Maiden Name: _____________________
_______________________
______________________
Maiden Last Name
First Name
Maiden Middle Name
Full Name of Spouse: _____________________
_______________________
______________________
Last Name
First Name
Middle Name
Applicant’s Facial Attributes (please encircle):
Normal Color of Hair:
Black
Brown
Blonde
Gray
White Other: _________
Natural Color of Eyes:
Black
Brown
Blue
Gray
Green Other: _________
Distinguishing Marks:
Moles …
on cheek
on forehead
on nose
Other:________
Birthmark…
on cheek
on forehead
on nose
Other:________
Scar…
on cheek
on forehead
on nose
Other:________
Other:___________________________________
I know that I can complete my application and take my oath during regular business hours on weekdays (except
official holidays) and wish to schedule an appointment for the Seminar and formal Oath-Taking Ceremony:
__________
_______ _______
_____
Day
Month
Date
Year
Applicant’s complete address:____________________________________________________________________________
Email Address:_______________________________
Home Phone Number:_________________________
Work Phone Number: __________________________
Mobile Number: ______________________________
Please contact me by (encircle):
Email
Home
Work
Mobile
Checklist of Supporting Documents enclosed:
For the Principal
□ Fully Accomplished “Petition for Dual Citizenship and Issuance of Identification Certificate”
□ Three (3) recent 2x2 photos (colored, plain background, and with collar)
□ Application fee of US $50.00 (cash or money-order payable to the Philippine Consulate General New York)
□ Submit two (2) copies of the following, and bring the originals on the appointment date:
o Certificate of Naturalization issued by the US
o US Passport (copy the data-page with photo)
o Latest Philippine Passport (copy the data-pages, photo, name, etc.)
o Philippine Birth Certificate (if born in the Philippines – NSO-issued Birth Certificate preferred) / Report of
Birth with sign/seal of the Consulate / Embassy with jurisdiction over the place of birth (if born abroad);
o If applicant’s name is different from the birth certificate, Notarized Affidavit of Change of Name
o Marriage contract printed on NSO Security Paper (if marriage was celebrated in the Philippines) or Report of
Marriage duly signed by the Embassy or Consulate which has jurisdiction over the place where the marriage
was celebrated if applicant’s marriage was celebrated abroad (please read through our Report of Birth,
Marriage, and Death Pages for guidance)
o If previously married: Marriage Certificate annotated by the NSO or Annulment/Divorce Decree
NOTE: if any of the above documents cannot be produced, call the Dual Citizenship Section at the numbers below
For each Dependent (unmarried children below 18 yrs old, born when both parents were already foreign citizens) submit:
□ Two (2) recent colored passport photos 2” x 2” against a plain background
□ Application fee of US $25.00 (cash or money-order payable to the Philippine Consulate General New York
□ Submit two (2) copies of the following, and bring the originals on the appointment date:
a) US Birth Certificate
b) US Passport (copy the data-page with photo)
Mail THIS FORM and the above supporting documents to: (USPS Priority mail w/ delivery confirmation suggested)
Philippine Consulate General New York
556 Fifth Avenue
New York, NY 10036
Attention: Dual Citizenship Appointment Coordinator
NOTE: Walk-in applicants are accepted Monday through Friday from 9:00 am to 12:00 noon. A Seminar, followed by the
Oath-taking, is conducted daily at 3:00pm.
For queries, email: or call 212-764-1330 ext 311 / 318; request for Merle Puruganan
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