Application For Quota / Nonquota Immigrant Visa
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3FA Form no. 3 (Revised 2000)
(Applicant’s
FOREIGN SERVICE OF THE PHILIPPINES
signed photograph)
Philippine Embassy
Berlin, Germany
APPLICATION FOR QUOTA / NON-QUOTA IMMIGRANT VISA
Instructions : This form should be accomplished in duplicate, the original to be given to the applicant and the
duplicate to be filed at the Post.
1. Surname
2. First Name
3. Middle Name
4. Sex
Male
Female
5. Date of Birth
6. Citizenship
(Day-Month-Year)
7. Place of Birth
8. Civil Status
Single
Married
Widowed
Separated
Divorced
9. If married, state name and address of spouse
10. Names and dates of birth of children
1.
2.
3.
11. Applicant’s address(es) for the last 5 years
1.
Since :
2.
Since :
3.
Since :
12. Occupation
Since :
13. Father’s Name
14. Mother’s Name
15. Place where the applicant intends to reside in the Philippines
16. Occupation to be pursued :
Name and address of employer, if any :
17. Nearest relatives in the Philippines
Name
Address
Relationship
1.
2.
18. Have you ever been institutionalized for any mental disorder?
Yes
No
If yes, state when and where:
19. Do you have any physical defect?
Yes
No
If yes, state nature of defect:
20. Have you ever been convicted of any crime?
Yes
No
If yes, state when, where, and nature:
21. Are you afflicted with any contagious disease?
Yes
No
If yes, state nature:
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