Republic of the Philippines Pi Form No.
APPLICATION FOR POSTALID CARD | 22:5:
ALLFIELDS WITH (~~) AREREQUIRED. foonrehesninceneirmteyasieaioct | oRN-— oka
PART | -TO BE FILLED OUT BY THE APPLICANT
‘A. APPLICATION TYPE
PURPOSE carvTyet | peuvery {RO REPLACEMENT
vender Name Amendment Athentetng Finger
Dona Desi Chrecotan | Cy pepcererteton crt Ci epncenent ot nagednd
Dh aevena | Chercmuw | Cause Dl hrencmerte aprox Deter
Exe ur ad
POSTAL REFERENCE NO.(eavbinkitNew Apcatin] RAE (HRSTHAME) ~~ (ue kane (ustauey sure
poiriiiy
ER BREF NDOT PCE TOT ORICA 7 RCE [coon
TREES E STAR ‘DOTA TASTE ory
TREES HADEN STE ‘DBT TaST ca
RITA IRCuRTaR ST
Lsnge CD vones vide Ce lovecat
Fisna TT enbeT THe Tenia Tava ae)
Ne TTT PATER nee a Wa mee)
aT TAT reowrceran [FEPFONE NUMBER TRENT
STNG RAR ETRE, WERT TT NCR CRT EES ERAT ORES
reas
PREFERRED MAILING ADDRESS (roosove) Conse Cl wonx
ed
"ADDRESS yourusunirno./s.. name) [vous tor 4 ux0) sree wane
‘BORDON aNCRTHITRETTBALTY
TaN CATT ROWING counrmry JPost ona
Litt
irene
‘ADDRESS (COMPRNTRNFLUUNTNO./BLD.KAME) [vous Lor uxN0) sree naney
‘BORDON TaaNeRTHITRETTBLTY
TeTMOWERALTIT ROWING coon JPost ave
Pit
eke
FINGERPRINTS IF APPLICANT CANNOT SIGN:
sang the condenty ofthe data tat have sporti, Ihre ve
‘ther purpores content wit he obec fh cae erate the tm ht by
‘Sewue core and complete tthe best of my sbonlege ae belt Further whe peng
RGHTTHONE TIGHT OER
APPLICANT'S SIGNATURE WITNESS’ SIGNATURE
SIGNATURE OVER PRINTED NAME DATE SIGNATURE OVER PRINTED NAME
PART II -TO BE FILLED OUT BY PHLPOST
SUPPORTING DOCUMENTS PRESENTED: "APPROVED BY
Lnso pit censtene 1 tarnoaycoiete
Totnes SIGNATURE OVER PAINTED NAME Dar
DATA CAPTURE SCHEDULE DATACAPTORED BY
ScHEENED BY ating a Ofce Name Cote
SIGNATURE OVER PRINTED NAW DATE | dite Tne SIGNATURE OVER PRINTED NAME OnE
TEAR HERE
Republic of the Philippines T ppicaton entelNo
PHLPOSTS. PHILIPPINE POSTAL CORPORATION | jv yc ouecase
APPLICATION FOR POSTALID CARD) se".
ACKNOWLEDGEMENT SLIP ( CLIENT COPY }
Pi} iittitt
APPROVED RY, ‘DATA CAPTURE SCHEDULE DATA CAPTURED
tring as Ofc Name oe
SIGNATURE OVER PAINTED NAME ATE daertine SIGNATURE OVER PRINTED NAME OnE
For Inquiries, Please Call Customer Service Hotline 52754092
3.
5.
6.
7
10.
1.
GENERAL TERMS AND CONDITIONS
The Postal Identification Card (or Card) is issued exclusively by Philippine Postal Corporation
(PHLPost) as proof of address and identity of the cardholder.
The card is a property of the cardholder.
The card is non-transferable.
A unique Postal Reference Number (PRN) is assigned to each cardholder.
The card is valid for three (3) years.
The cardholder is responsible for the proper use of his/her card at all times and must keep
the card secure.
Alteration or intentionally damaging the card, using another person's card, or allowing the
card to be used by another person is not allowed and it may result in confiscation and/or
termination of the card as well as legal action(s) by government enforcement agencies and
PHLPost,
If card is lost, stolen or damaged, the cardholder must report it to the Postal Payment
Services Division, Business Lines Department by mail, email and/or call within five (5) days:
Malling address: The Postal Payment Services Division
Business Lines Department
5/F Manila Central Post Office Bldg
LiwasangBonifacio
1000 Manila City, Philippines
Email ppsdiv.bld@phipost.gov.ph
psdiv.bld.phipostagmail.com
Telephone No: +6325275872
Fax No: +6325270151
8.1 The cardholder may request for replacement of the lost, stolen or damaged card.
to any post office, subject to compliance to the requirements for replacement and
payment of applicable fees and charges
PHLPost is not responsible for any unauthorized use of the card or for any loss arising from
the failure of the cardholder to comply with these terms and conditions.
A list of documentary requirements for application of a Postal ID is available at all post
offices and at the PHLPost website (www-phlpost.gov.ph).
By applying for and/or using the card, the cardholder agrees to the terms of its issuance as
governed by the PHLPost regulations.
If the cardholder was found to have provided false information, falsified documents or has
willingly applied for a Postal ID through fraudulent means, he/she may be subjected to legal
sactions,