PID Form No.
Re p u bl i c o f t h e P h i l i p p i n e s
Revision (No.) (Date)
PHILIPPINE POSTAL CORPORATION Application Control No.:
APPLICATION FOR POSTAL ID CARD Accepting Post Office Code:
Accepting Post Office Name:
OR No: OR Date:
ALL FIELDS WITH ( ) ARE REQUIRED PLEASE READ THE GENERAL TERMS AND CONDITIONS AT THE BACK BEFORE ACCOMPLISHING
POSTAL REFERENCE NO. (Leave blank if New Application)
THIS FORM. PRINT ALL INFORMATION IN CAPITAL LETTERS AND USE BLACK INK ONLY.
PART I - TO BE FILLED OUT BY THE APPLICANT
A. APPLICATION TYPE
PURPOSE DELIVERY CARD REPLACEMENT
Amendment of Name Amendment of Authenticating Finger
INITIAL REGULAR
Replacement of Lost Card Replacement of Damaged Card
RENEWAL RUSH Amendment of Biographic Data Others
B. APPLICANT DETAILS
APPLICANT’S NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)
JAYSON DELA CERNA CASTRO
GENDER DATE OF BIRTH (MM/DD/YYYY) PLACE OF BIRTH (CITY/MUNICIPALITY) (PROVINCE) (COUNTRY)
MALE 11 2 7 1 9 9 5 QUEZON CITY GEN. HOSPITAL PHILIPPINES
FATHER’S NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)
ANTONIO LIWALAS CASTRO
MOTHER’S MAIDEN NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)
JUDITH VILLAREN DELA CERNA
NATIONALITY OCCUPATION CIVIL STATUS
FILIPINO / Single Married Widowed Separated Divorced/Annulled
GSIS No.(If GSIS member) SSS No.(If SSS member) TIN No.(If Available)
3 4 6 7 1 1 4 5 5 2
CRN No.(If Available) PHILHEALTH No.(If member) HDMF No.(If member)
NOT FOR SALE
NOT FOR SALE
0 2 2 5 0 5 9 2 1 6 1 9
EYES (COLOR) HAIR (NATURAL COLOR) COMPLEXION TELEPHONE NUMBER MOBILE NUMBER
367-2532 09666098366
DISTINGUISHING FACIAL FEATURES WEIGHT (KILOS) HEIGHT (CENTIMETERS) EMAIL ADDRESS
C. ADDRESS DETAILS
PREFERRED MAILING ADDRESS (CHOOSE ONE) PRESENT WORK
PRESENT ADDRESS
(RM/FLR/UNIT NO./ BLDG. NAME) (HOUSE/ LOT & BLK NO.) (STREET NAME)
# 84 N. GARCIA ST. BAGONG BARRIO
(SUBDIVISION) (BARANGAY/DISTRICT/LOCALITY)
BARANGAY 146, ZONE 13, DISTRICT 1
(CITY/MUNICIPALITY) (PROVINCE) (COUNTRY) (POST CODE)
CALOOCAN CITY PHILIPPINES 1400
WORK ADDRESS
EMPLOYMENT STATUS COMPANY TYPE
Contractual Regular / Permanent Household Self Employed OFW Government Private Others
(COMPANY/RM/FLR/UNIT NO./BLDG. NAME) (HOUSE / LOT & BLK NO.) (STREET NAME)
(SUBDIVISION) (BARANGAY/DISTRICT/LOCALITY)
(CITY/MUNICIPALITY) (PROVINCE) (COUNTRY) (POST CODE)
D. APPLICANT’S CERTIFICATION
Notwithsta nding the co nfide n t i al i t y of t h e d at a t h at I h av e s u p p l i ed h erei n , I h ereby give m y Further, all statem ents/data on the FINGERPRINTS IF APPLICANT CANNOT SIGN:
conse nt tha t the sa m e be s ecu red an d acces s ed f or s u b s eq u en t v al i d at i on , v erific ation, and operator's sc reen, whic h were shown to m e
ot he r purpo se s co nsis te nt wi t h t h e ob j ect i v es of t h i s card en rol l men t . I f u rt h er affirm that at or about the tim e I affixed m y signature
by a ffixing m y s igna ture o n t h i s f orm, al l s t at emen t s /d at a ap p eari n g i n t h i s f orm are true, herein, are true, c orrec t and c om plete to the
corre ct a nd co mple te . While ap p l y i n g f or t h i s card , I l i kew i s e f u l l y ag ree t o an d understand best of m y k nowledge and belief.
all the te rms o f its iss ua nce as g ov ern ed b y P os t al ru l es an d reg u l at i on s .
Higit pa rito, ang ak ing lagda sa form na ito
Ibinibiga y ko a ng a king pa hi n t u l ot n a g ami t i n an g mg a komp i d en s y al n a i mporm asyong ay nagpapatunay na ang lahat ng
naka sa a d sa ita a s sa pa gpa p at u n ay, p ag b eb eri p i ka at i b a p an g p amamaraan g k augnay sa im porm asyong m ak ik ita sa k om pyuter sc reen
pr os e so ng pa gga wa ng Po st al I D . An g aki n g l ag d a s a f orm n a i t o ay n ag p ap atibay na ang ng operator ay totoo, tam a at k um pleto sa
laha t ng im po rm a sy o ng ma kiki t a s a f orm n a i t o ay t ot oo, t ama at ku mp l et o. N aiintidihan k o ak ing buong k aalam an at paniniwala.
r in a t suma s a ng- a yo n a ko sa mg a al i t u n t u n i n at reg l amen t o n a s u mas akl aw s a pagk ak aroon
ng Po s ta l ID ca rd. RIGHT THUMB RIGHT INDEX
APPLICANT’S SIGNATURE APPLICANT’S SIGNATURE WITNESS’ SIGNATURE
SIGNATURE OVER PRINTED NAME DATE SIGNATURE OVER PRINTED NAME DATE SIGNATURE OVER PRINTED NAME
PART II - TO BE FILLED OUT BY PHLPOST
SUPPORTING DOCUMENTS PRESENTED: APPROVED BY:
NSO Birth Certificate Barangay Certificate
Others SIGNATURE OVER PRINTED NAME DATE
DATA CAPTURE SCHEDULE DATA CAPTURED BY:
DATE
SCREENED BY: Capturing Post Office Name / Code:
SIGNATURE OVER PRINTED NAME DATE Date / Time: SIGNATURE OVER PRINTED NAME
TEAR HERE
Re p u bl i c o f t h e P h i l i p p i n e s Application Control No.:
PHILIPPINE POSTAL CORPORATION Accepting Post Office Code:
APPLICATION FOR POSTAL ID CARD ACKNOW LEDGEMENT SLIP ( CLIENT COPY )
Accepting Post Office Name:
OR No : OR Date:
POSTAL REFERENCE NO. (Leave blank if New Application) NAME (FIRST NAME) (MIDDLE NAME) (LAST NAME) (SUFFIX)
APPROVED BY: DATA CAPTURE SCHEDULE: DATA CAPTURED BY:
Capturing Post Office Name / Code:
SIGNATURE OVER PRINTED NAME DATE Date / Time: SIGNATURE OVER PRINTED NAME DATE
GENERAL TERMS AND CONDITIONS:
a. The Improved Postal ID is issued exclusively by PHLPost as proof of address and identity of the cardholder.
b. The card is the property of the cardholder.
c. The card is non-transferable.
d. A unique Postal Reference Number (PRN) is assigned to each cardholder.
e. The card is valid for three (3) years for Filipinos and foreign residents with Diplomatic Visa for foreign government officials/
personnel serving in foreign embassies or consulates in the Philippines, Long Stay Visitor Visa Extension, Temporary Resident Visa
and Special Resident Retiree’s Visa while one (1) year for foreign residents holding Alien Certificate Registration Identity Card and
any equivalent document allowing the applicant to stay in the Philippines for three (3) months or more issued by the Bureau of
Immigration and or Department of Foreign Affairs.
f. The cardholder is responsible for the proper use of his/her card at all times and must keep the card secure.
g. Alteration or intentional damage to the card, using another person’s card, or allowing the card to be used by another person is
not allowed and it may result in confiscation and/or termination of the card as well a legal action/s by government enforcement
agencies and PHLPost.
h. If card is lost, stolen or damaged, the cardholder must report to the Postal Payment Delivery Division, Business Lines Department
(PPDD-BLD) by SMS, email, call and/or mail within five (5) working days:
Mailing address: The Postal Payment Delivery Division Mobile No: (0917) 5215373
Business Lines Department (0998) 8847629
5/F Manila Central Post Office Bldg. (0925) 3212291
Magallanes Drive
1000 Manila, Metro Manila Website: www.phlpost.gov.ph
E-mail Address: phlpostal.payment@gmail.com
ppsddiv.bld.phlpost@gmail.com
i. The cardholder may request for replacement of the lost, stolen or damaged card to any post office, subject to compliance to the
requirements for replacement and payment of applicable fees and charges.
j. The PHLPost is not responsible for any unauthorized use of the card or for any loss arising from the failure of the cardholder to
comply with item G of this guideline.
k. If the cardholder is found to have provided false information, falsified documents or has willingly applied for a Postal ID through
fraudulent means, he/she may be subjected to legal action/s and/or sanction/s.
l. By applying for and/or using the card, the cardholder agrees to the terms of its issuance as governed by the PHLPost regulations.
m. Privacy Statement. The personal information that PHLPOST being provided is necessary to complete this application and/or
transaction. Said information will be kept confidential and secure, and shall not be used without the express consent of the data
subject..
For Inquiries, Please Call Customer Service Service Hotline (02) 742-7349 / (02) 230-9875,
Globe - 09175215373, Smart - 09988447629, Sun - 09253212291, Mondays to Fridays from 8AM to 5PM
Visit: www.facebook.com/newpostalid, www.postalidph.com
