CHECKLIST OF REQUIREMENTS AND INSTRUCTIONS FOR REPORT OF BIRTH. PLEASE READ THE INSTRUCTIONS CAREFULLY.:

The Embassy will not process your application unless all of the following requirements are complied with. Processing time is approximately five (5) working days.

 Report of Birth Form to be duly accomplished in Quadruplicate (four original copies). If you downloaded the Report of Birth Form from the Internet, kindly print the Form four times, including the back page, and accomplish accordingly. To avoid erasures in filling up the Form, read carefully before filling up the blank fields.  Original and four photocopies of the Birth Certificate of the child. This should be the Acte de Naissance Copie Integrale (Extrait or Acte de Reconnaissance is insufficient).  Original and four photocopies of the Marriage Contract or Acte de Mariage of the child’s parents. If married in France or Portugal, the original and four photocopies of the Report of Marriage should likewise be submitted.  Four photocopies of the passport of the child’s father, and four photocopies of the passport of the child’s mother.  Four passport-size photos of the child in plain white background. If applying for a passport for your child, four passport-size photos in royal blue background will be additionally required. Please note that passport applications are processed and paid for separately.  Affidavit of Late Registration for children more than 12 months old at the time his or her birth is reported at the Philippine Embassy.  Affidavit of Acknowledgment or Admission of Paternity, if applicable (unmarried parents).  Payments should be made either in the form of cash or Mandat Cash payable to Ambassade des Philippines. Payments made through credit card or in the form of personal checks are not accepted. SCHEDULE OF FEES

FOR MAILING OPTION, PLEASE INDICATE

NAME: _________________________________ • €25 for the Report of Birth • Additional €25 Affidavit of Paternity or COMPLETE MAILING ADDRESS: Acknowledgment, if applicable • Additional €25 Affidavit of Delayed Registration, if applicable • Additional €7 for mailing the Report of Birth to your residence (Mailing Option)→

Latest Photo of Child Passport-Size Full frontal view and without eyeglasses

EMBASSY OF THE PHILIPPINES Paris, France REPORT OF BIRTH Child Born Abroad to Philippine Parent(s) REGISTRY NUMBER: PA-_____________________

INSTRUCTIONS: PLEASE FILL OUT CAREFULLY AND IN CAPITAL LETTERS. MARK THE APPROPRIATE BOXES WITH AN “X” AND “N/A” IF NOT APPLICABLE. PLEASE AVOID ERASURES AS MUCH AS POSSIBLE. FAMILY NAME OF THE CHILD Apelyido ng bata FIRST NAME OF THE CHILD Pangalan ng bata MIDDLE NAME OF THE CHILD Apelyido ng pagkadalaga ng ina ng bata DAY MONTH IN WORDS YEAR DATE OF BIRTH Araw ng kapanganakan CITY PROVINCE COUNTRY PLACE OF BIRTH Lugar ng kapanganakan ng bata PARENTS ARE STATUS OF THE CHILD GENDER OF THE CHILD NATIONALITY OF THE CHILD  Single Legitimate Male Filipino  Married to each other Illegitimate Female PARENTS LAST NAME Apelyido (ng pagkadalaga) FIRST NAME Pangalan sa pasaporte MIDDLE NAME Panggitnang apelyido DATE OF BIRTH Araw ng kapanganakan NATIONALITY PLACE OF BIRTH Lugar ng kapanganakan OCCUPATION Trabaho PASSPORT NUMBER DATE OF ISSUE OF PASSPORT Araw ng pagkakaloob PLACE ISSUED CURRENT ADDRESS

FATHER

MOTHER

DAY

MONTH in WORDS

YEAR

DAY

MONTH in WORDS

YEAR

DAY

MONTH in WORDS

YEAR

DAY

MONTH in WORDS

YEAR

ADDRESS IN THE PHILIPPINES DATE OF MARRIAGE OF PARENTS PLACE OF MARRIAGE OF PARENTS NUMBER OF PREVIOUS CHILDREN:

NUMBER OF CHILDREN NOW LIVING:

SIGNATURE OF FATHER When reported by mail, please sign this report in the presence of at least two witnesses of legal age. Declared to in our presence this ____ day of __________________, _________. Signature over printed name of first witness: _________________________________________________________________ Address: _________________________________________________________ Signature over printed name of second witness: _________________________________________________________________ Address: _________________________________________________________ COPY FOR THE:  PHILIPPINE EMBASSY  APPLICANT

SIGNATURE OF MOTHER REPORTED AT THE EMBASSY PHILIPPINES IN PARIS, FRANCE THIS

OF

THE

_____________________________________________

 OCA-CRD per FSC 137-09

 NATIONAL STATISTICS OFFICE

AFFIDAVIT OF ACKNOWLEDGMENT/ADMISSION OF PATERNITY I, _________________________________________________________, a __________________________ citizen, single, of legal age, and presently residing at ________________________________________________________________________ do hereby declare and state that I am the father of ___________________________________________________________________________________ born on ________________________________________ in _______________________________________________; that the child’s mother and I are not married; and that I would like the child to bear my surname pursuant to Republic Act No. 9255 (An Act Allowing Illegitimate Children to Use the Surname of their Father, Amending for the Purpose, Article 176 of Executive Order No. 209, otherwise known as the Family Code of the Philippines) series of 2004.

Passport Number _________________________

_______________________________________ Signature of Father

Date and Place of Issue ____________________ SUBSCRIBED AND SWORN TO BEFORE ME THIS ______________________________________ at the Embassy of the Philippines, Paris, France.

AFFIDAVIT OF LATE REGISTRATION OF CHILD I, _________________________________________________________, a __________________________ citizen, of legal age, and presently residing at ________________________________________________________________________ do hereby declare and state that I am the parent of ______________________________________________________________________________________ born on ________________________________________ in _______________________________________________; that I was not aware that the birth of a Filipino child abroad (a child born to Philippine parent/s) should immediately be reported to the nearest Philippine Embassy or to the nearest Philippine Consulate for registration; that in view of my lack of knowledge of the existing requirement, I failed to register the birth of my child; and that I am executing this affidavit in order to attest to the facts and circumstances surrounding the late registration of the birth of my child.

Passport Number _________________________

_______________________________________ Signature

Date and Place of Issue ____________________ SUBSCRIBED AND SWORN TO BEFORE ME THIS ______________________________________ at the Embassy of the Philippines, Paris, France.

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