VCU Form 3
THIS FORM IS NOT FOR SALE, REPRODUCTION IS ALLOWED Jan. 2007
CERTIFICATION REQUEST FOR TRAVEL RECORDS
Date : __________, 20____ (Please Print your Answer)
DATE / TIME
NOTE :
The Passenger Manifest of Arrival/Departure (below 1993) proceed to Records Section (3rd Floor, Room 301).
THE COMMISSIONER INTRAMUROS, MANILA
RECEIVED
VCU window
BUREAU OF IMMIGRATION
Dear Commissioner ;
______________
May I request for a certification for travel records of subject :
SURNAME FIRSTNAME MIDDLE NAME OTHER NAME
Please Check the approximate box :
EMBASSY PURPOSES _____________________________________________________ ( write embassy ) COURT/LEGAL PURPOSES _____________________________________________________ ( filing court / branch / contact # )
FOUNDATIONS
(please check the box)
GREENLIFE
[Link]
TECO
STEP
OTHERS ____________________
OTHER INFORMATION
SEX (please check one) DATE OF BIRTH PLACE OF BIRTH NATIONALITY
Month M F Day Year
PHILIPPINE ADDRESS
PASSPORT NO. TEL. NO./CELL NO. ARRIVAL DATE FLIGHT NUMBER DEPARTURE DATE FLIGHT NUMBER
Very truly yours,
DO NOT FILL THIS PORTION (FOR EMPLOYEES ONLY)
NO RECORD ON FILE
SIGNATURE of Requesting Party
ARRIVAL [for COMPUTER SECTION-VCU only] : FROM: _________________________ TO: __________________________ DEPARTURE : FROM : __________________________ TO: ___________________________
Verified by : _________________ Date / Time : ________________
NOTE
[for RECORDS SECTION only]
PRINTED NAME of Requesting Party
NOTE : Please see BACK PAGE for LIST OF DOCUMENTARY REQUIREMENTS for submission.
VCU Form 3
Bureau of Immigration Verification & Certification Unit
DATE / TIME FILED:
CLAIM STUB for travel cert.
Name of Subject : ___________________________________________________________ Date of Birth : __________________
DATE / TIME released :
Nationality : __________________________
2 to 3 hours processing upon payment depending on the volume of application Always present this receipt upon claiming your certificate Unclaimed certificate shall be automatically cancelled after 30 days from the date of issuance If not the claimant of certificate, present any valid ID Cards
FRONT PAGE
SPECIFIC REQUIREMENTs :
EMBASSY PURPOSES :
Attached xerox copy of PASSPORT (Optional) one xerox valid ID
COURT /LEGAL PURPOSES :
Attached LETTER REQUEST from requesting office & one xerox valid ID
FOUNDATIONS :
Attached xerox copy of passport (optional) one xerox valid ID
CERTIFICATION FEES :
Certification Legal Research Express Fee 500.00 10.00 500.00
TOTAL
Ph P 1,010.00
Collected under C.A. No. 613, Section 42(A)(19) With MEMORANDUM ORDER NO. 02-045 dated 26 September 2002
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