DEPARTMENT OF NATIONAL DEFENSE

SINGLE ID SYSTEM
RETIREE / VETERAN

WRITE LEGIBLY IN BLOCK CAPITAL LETTERS

(ISULAT SA PAMAMAGITAN NG MALAKING TITIK ANG MGA SAGOT)
ID NO: __________________
RETIREE/ VETERAN INFORMATION:
OFFICER ENLISTED PERSONNEL NON-AFP PENSIONER

LAST NAME: ____________________________________________

FIRST NAME: ____________________________________________
(MOST RECENT 2 X 2
MIDDLE NAME: _________________________________________ COLORED PICTURE IN
FORMAL/SMI FORMAL
RANK: ______AFPSN: ____________ BR. SV. ______ RET DATE: ____/____/_____ ATTIRE WITH WHITE
MM DD YYYY BACKGROUND IN
PROPER HAIRCUT, NO
MUSTACHE/BEARED
ADDRESS: _______________________________________________________________ AND NO EYE GLASSES)
HOUSE NO./ STREET/ BRGY. DISTRICT /MUNICAPALITY CITY/PROVINCE

DATE OF BIRTH: _____/____/______ PLACE OF BIRTH: ____________________

MM DD YYYY
RELIGION: ______________________________________________________________
STATUS: _________ (Single /Married/ /Separated/Widowed) NAME OF SPOUSE: ________________________________

LIVING (YES/NO) ______________ IF DECEASED, DATE OF DEATH: _____/____/______

MM DD YYYY

HEIGHT (cm): ______ WEIGHT (kg): ______ BLOOD TYPE: _______

PHILHEALTH NO.: ____________________________________________

PHIL NATIONAL ID NO: _______________________________________
TIN NO. ____________________ AFP OR VMMC ID: ________________
KEEP SIGNATURE INSIDE THE BOX
MOBILE NO: ______________________ EMAIL: _____________________ (PLEASE USE BLACK SIGN PEN)

NAME OF PARENTS FATHER MOTHER

LAST NAME: ________________________ ________________________
FIRST NAME: ________________________ ________________________
MIDDLE NAME: ________________________ ________________________

VETERAN ORGANIZATION AFFILIATED: __________________________________

PERSON TO BE NOTIFIED IN CASE OF EMERGENCY
NAME AND RELATIONSHIP: _____________________________________________
ADDRESS: ______________________________________________________________
TELEPHONE NO.: ________________________________________________________
RIGHT THUMBMARK

Statement of Consent
I certify and affirm that all information which appear in this form and made by me are true and correct.; I have been advised of my rights as a data
subject under RA 10173 or the Data Privacy Act of 2012; I give my consent to the processing of my personal data for subsequent validation,
verification for the issuance of my Single ID; and, I authorize PVAO to access my/veteran’s civil records with the Philippine Statistics Authority
(PSA) and other government agencies.

_______________________ ___________________________________________________
DATE SIGNED SIGNATURE OVER PRINTED NAME

TO BE FILLED-IN BY VRMD (Frontline Service)

EXAMINED BY: _________________________________
ENCODED BY: _________________________________
BIO / PRINTED BY: ______________________________
REMARKS:

NOTE:
THIS FORM IS FREE OF CHARGE.
PLEASE SUBMIT THIS FORM AND THE REQUIREMENTS TO:
VETERANS RECORDS MANAGEMENT DIVISION
Philippine Veterans Affairs Office
Camp Gen Emilio Aguinaldo, Quezon City
Application Requirements

FOR AFP Retirees:

Case #1: For those who can personally apply (Para sa mga Personal na makakapag-apply):
1.1 Duly accomplished prescribed Application Form
(Punan ang Application Form ng kumpletong impormasyon tungkol sa aplikante);
1.2 Authenticated copy (in original mark) of Retirement Order from Non-Current Records Division, Office of The Adjutant
General (OTAG).
1.3 For lost AFP ID Card recently issued a notarized Affidavit of Loss or Police Blotter must be submitted and pay the
replacement fee amounting to one hundred fifty pesos (150.00). (Kung ang AFP ID ay nawala at ito ay bagong issue
lamang, maari lamang na magsumite ng Affidavit of Loss o Police Blotter at bayaran ang kaukulang replacement fee sa
halagang isang daang at limampung piso (150.00)

Case #2: For those who cannot personally appear the following are the additional requirments (Para sa mga hindi makapag-
apply ng Personal ito ang mga karagdagan dokumento na kailangan):
2.1. Prepaid LBC or self-addressed stamped envelope for return mail and replacement cost if the ID is lost. (Prepaid LBC or self-
addressed stamped envelope para sa return mail at pamalit na halaga kung Nawala ang ID)
2.2 Proof of Life: Clear snapshot/ photo of the retiree holding a current newspaper with the headline and date of publication
prominently displayed, or photo of the retiree with the background of the news crawler or ticker on TV showing the
current headline and date (Proof of Life: Malinaw na snapshot/ larawan ng retirado na may hawak na kasalukuyang
pahayagan na ang headline at petsa ng publikasyon ay kitang-kita , o larawan ng retirado na may background ng news
crawler o ticker sa TV na nagpapakita ng kasalukuyang headline at petsa)
2.3. If the applicant is living abroad, photocopy if valid passport must be submitted as additional documentary requirements.
(Kung ang aplikante ay nakatira sa ibang bansa, ang photocopy ng valid na pasaporte ay dapat isumite bilang karagdagang
mga kinakailangan sa dokumentaryo)

IMPORTANT REMINDER (Mahalagang Paalala):

1. If pensioner is unable to write/sign legibly, affix thumbprint on the space provided for the signature; (Kapag ang
pensiyoner ay hindi na nakakasulat o hirap nang magsulat, maari lamamng lagyan ng thumbmark ang espasyong nkalaan
para sa lagda ng retirado);
2. In case that there is/are amputation or deformity of the fingers/hands, indicate such on the space/spaces provided for
(Kung and daliri o kamay ng pensioner ay naputol o may kapansanan, maari lamang na isulat ang dahilan sa espasyong
nakalaan para dito)
3. Edited/enhanced/blurred pictures are not accepted (Ang mga litrato/larawan na na-edit, pinaganda o malabo ay hindi
tatanggapin.

REPLACEMENT OF LOST/DAMAGED/CORRECTIONS ID CARD:

(Pagpapalit ng Nawala/Nasira o may Mali o Pagbabago sa ID Card):
1. If reason of replacement is due to undelivered mail, secure CERTIFICATION from your post office stating non-receipt of the
AFP Retiree/Veteran ID Card. Proceed to Case #2 for non-appearance, or whichever case is applicable/accessible for your
convenience (Kung ang rason sa pagpapalit ng ID ay dahil sa hindi nai-deliver na sulat, humingi ng CERTIFICATION mula sa
Post Office kung saan nakasaad ang hindi pagkakatanggap ng inyong ID Card. Sundin ang proseso sa case No. 2, o kung
alin alin mang prosesong nararapat).
2. For lost AFP Retirees ID Card recently issued and not yet expired, a notarized Affidavit of Loss or Police Blotter must be
submitted and pay the replacement fee amounting to one hundred fifty pesos (150.00) thru the PVAO’s Cashier Office.
(Kung ang AFP ID ay nawala at ito ay bagong issue lamang o hindi pa expired, maari lamang na magsumite ng Affidavit of
Loss o Police Blotter at bayaran ang kaukulang replacement fee sa halagang isandaan at limampung piso (150.00) sa
PVAO’s Cashier Office
3. For AFP Retirees ID with clerical errors/discrepancies on names, date of birth or other data therein, submit the following
(Para sa clerical na pagkakamali sa pangalan, petsa ng kapanganakan, o iba pang datos, isumite lamang ang mga
sumusunod):
5.a. Request letter for correction stating the error/discrepancy to be corrected;
(Sulat kung saan nakasaad ang pakakamali at kung ano ang dapat itama sa mga datos)
5.b. Documents/Proof of correct data/information (Mga dokumento na katunayan ng
tamang datos)

NOTE: PVAO HAS THE RIGHT TO REQUIRE OTHER DOCUMENTS AS MAY DEEMED NECESSARY.
(Ang opisina ng PVAO ay maaring manghingi ng karagdagang documento kung nararpat at kinakailangan)