BI FORM CGAF-002-Rev 3 ‘This document may be reproduced and Is MOT FOR SALE ‘CONSOLIDATED GENERAL APPLICATION FORM FOR NON-IMMIGRANT VISA, SPECIAL WORK PERMIT AND PROVISIONAL WORK PERMIT [excert STUDENT VISA AND SSP] ‘character References i tha Philippines 9 CODCOTTE Trt) Rad ‘conn umbers) ithe Fipnes i TT) = [| I wee matey Ti L im] LITT aL 1] [ I ‘stant Koes contact tumbers) the Plippoes unio ete TTT) TT is None, a, Me as i. I I I I I ‘Commerce (] Rabon [Ly cote tne psi ghsared adres i the I im] \VIAPPLICANT'S OTHER | f ane iD 5 HT we Steno 11 a cy 340 3900) ma I [al CERTIFICATION [We cartify that: (1) Al the Information in the application is truthful, complete and corres ; (2) All documents ar autre war gly bane fom he cova ing government agencies or private entities; (3) /We understand that polation may be summary deried Hf: (@) Any statement is fase: (6) OY ofan te ‘submitted is falsified: “or (@) 1/We fall to comply with all ‘the BI requirements without prejudice to whatever action the BI may take; and (4) I/We have not filed this or any similar application before any office of the Bureau. Petitioner's Signeture over Printed Name Applicant's Signature over Printed Name Date DOMME eg. 01 JAN 1990] "AORI-CARD WILL ONLY ese rer ENP aie poet ite te A Scar opiate «mor fn precaceT cr y oart agen o m frm Leper er ory (S90), ced Dyan aorand preventive cher than om Tarerhor Bracing enthy AER Card Har lament = ‘igabire over PRDVTED HARE are (Wene cal (4652) 525-7557 to check the statu of your application) Page 20t 22 BI FORM CGAF-002-Rev 3 ‘This document may be reproduced and ls NOT FOR SALE & gage) CONSOLIDATED GENERAL APPLICATION FORM FOR NON-IMMIGRANT VISA, SPECIAL WORK PERMIT AND PROVISIONAL WORK PERMIT [except STUDENT VISA AND SSP] 1 APPLIGATION 2VFORMATION { L LT i I fetes [Sorweden TJetunien [CJoetnin perme maar Tr EODDEEE LL ~~ /-. et J PECCCCCCCCCCeeeeer Oo a we TH TIETE[El iomenes (eLeIeIaI=] alia} LIF THE ACR I-CARD 1S GLAIMED BY AN AUTHORIZED REPRESENTATIVE, PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS.) Page 1 of 2