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

IBP Bukidnon 54884

SURNAME FIRST NAME MIDDLE NAME

DAMASCO ALVY BERTOS

SEX CIVIL STATUS AGE DATE OF BIRTH PLACE OF BIRTH
F M Married 45 05/21/1976 MALAYBALAY CITY, BUKIDNON

RESIDENCE ADDRESS MOBILE NUMBER (enter 10-digit number)

07-15 CAPT. JUAN MELENDEZ ST., 8700 MALAYBALAY CITY, BUKIDNON
(997) 850-9273 e.g. 9151234567

OCCUPATION/EMPLOYMENT

LAWYER

FIELD OF SPECIALIZATION EMAIL ADDRESS

damascoalvy@gmail.com

LAW SCHOOL YEAR ADMITTED TO BAR

LICEO DE CAGAYAN UNIVERSITY 2008

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,
ALVY B. DAMASCO DATE:
please do not forget to attach your __________________________
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:
07-15 CAPT. JUAN MELENDEZ ST., 8700 MALAYBALAY CITY, BUKIDNON
_____________________________________________________
_____________________________________________________
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)

_____________________________________________________

ALVY B. DAMASCO
_______________________________ ______________________________
Signature of Applicant Signature of Applicant

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