Postal ID Application Form

Form No. 391 (Rev. 2001)

Application for Postal I.D. Republic of the Philippines The The Post Postma mast ster er

PHIL PHILIP IPPI PINE NE POST POSTAL AL COR CORPORA PORATI TION ON

____ ______ ____ ____ ____ ____ ____ ____ ____ ____ ____ ___  _  Date

Sir/Madam I have the honor to apply for a Postal I.D. Attached are four (4) identical copies of my picture (2"x2") and One Hundred Hundred Fifty Pesos for the fee therefore. My personal circumstances are as follows:

Surname

First Name

Occupation ___________________ ___________________________ ________

Middle Name Nationality ____________________ 

Residence _____________________ ___________________________________________ _____________________________________  _______________  Place of Birth Date of Birth ______________________ _________________________ ___ Hair Color:_____________ Color:_______________________  __________  Height ______________ Eyes ____________ ____________

Complexion ___________________ 

Distinguishing marks ____________________ ______________________ __ ______________________ ____________________________  ______   __________________________________________  ____________________ ____________________________________________ _________________________  ___  Witness to Thumbmark 1. _____________________ _____________________________  ________ 

 ________________________________________ 

2. _____________________________

Applicant's Signature

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Statement of Issuing Postmaster I hereby certify that I have this _______ day of _____________________ ______________________, _, 20 ______ issued Postal Identification Card No.   ___________________ on the foregoing application strictly in accordance with Sections 733-737 of the Postal Manual of the Philippines. The applicant exhibited to me his/her Community Tax Certificate No. _____________________ issued at ___________________  on _________________________ . No Community Tax Certificate because _________________________________________ _____________________________________________ ____ . Cross out words not applicable Application fee paid under Official Receipt No. ___________

Postmaster's Signature ______________________________  

Dated _____________________

Printed Name ______________________________________  

Post Office of ______________________________________  ______________________________________  -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Support Affidavit of Witness I, ___________________________________ ___________________________________ solemnly swear that I have known M ______________________________________  ______________________________________   _____________________  ___________________ __ , whose picture appears below, personally for _______ years and I know him/her to be the person who made the foregoing application, and that his/her personal circumstances as stated above are true to the best of my knowledge and belief.

Signature _____________________ ________________________________________  ___________________  Position/Occupation of Witness

Printed Name _____________________________________   Post Office of _____________________________________ 

Name of Office Subscribed and sworn to before me this _______ day of _____________________ ____________________________ _______ 20 ____ at the City/Municipality of  _________________________________________  ___________________ ______________________ . The affiant exhibited to me his/her Community Tax Certificate No. _____________________  issued at _____________________ ______________________________ _________ , _____________________ ___________________________________________ ______________________ on _______________________ , 20 No Community Tax Certificate because ______________________ ____________________________________________ _____________________________________________ _____________________________________ ______________ . Cross out words not applicable  _________________________________________________  Signature of authorized Officer Documentary Stamp

 _________________________________________________  Printed Name  _________________________________________________  Title of Officer