Integrated Bar of the Philippines

IBP Lawyers ID Form_v062020

IBP LAWYERS ID FORM (Please write in capital letters)

IBP CHAPTER ROLL NUMBER LIFETIME MEMBER NUMBER
72027
IBP Aklan
SURNAME FIRST NAME MIDDLE NAME
MAYOR AICEL JOY JAVILLO

SEX CIVIL STATUS AGE DATE OF BIRTH PLACE OF BIRTH

F M 33 09/18/1987 ALTAVAS AKLAN
Married

RESIDENCE ADDRESS MOBILE NUMBER (enter 10-digit number)

UNIT 2531 TOWER B JAZZ RESIDENCES N. GARCIA ST. BEL-AIR 9152854800
e.g. 9151234567

OCCUPATION/EMPLOYMENT
SERVICE MAN

FIELD OF SPECIALIZATION EMAIL ADDRESS

aj_shichou515@yahoo.com

LAW SCHOOL YEAR ADMITTED TO BAR

PAMANTASAN NG LUNGSOD NG MAYNILA 2018

ID PHOTO SIGNATURE PAYMENT DETAILS

I.D. OR. NO.

Upon submission of this form via

email to ibpaccounting@yahoo.com
and ibprecords.id@gmail.com, AICEL JOY J MAYOR
please do not forget to attach your __________________________ DATE:
2x2" ID photo in image format Signature over printed name
(e.g. .jpg or .png).
ASSESSED BY:

AUTHORIZATION FOR DELIVERY BY COURIER: AUTHORIZATION FOR PICK-UP:

I hereby authorize the IBP National Records Office to
deliver the requested IBP ID to my mailing address
indicated below via LBC or any other courier:
Mailing Address:
I hereby authorize the IBP National Records Office to
release the requested IBP ID to:
________________________________________
(Name of Authorized Representative)

_____________________________________________________
(please attach in the email the scanned copy of ID of
_____________________________________________________ Authorized Representative upon submission of this form)

_____________________________________________________

_______________________________ ______________________________
Signature of Applicant Signature of Applicant

Reset Form Save

IBP Building, No.15 Doña Julia Vargas Avenue, Ortigas Center, Pasig City, Philippines 1600
+63 (02) 631-3018 | +63 (02) 634-4696 | info@ibp.ph