AIU Form No.
001
Series of 2016
REPUBLICOFTHEPHILIPPINES
AURORA PACIFIC ECONOMIC AND FREEPORT ZONE
GENERAL APPLICATION FORM
Warning and Directions:
1. Indicate “N/A” if Not Applicable. Do not leave any space blank.
Print all information.
2. Application forms not properly accomplished will be summarily denied.
3. Giving of false information by the applicant/representative is a attach
basis for summary denial of application. 2 x 2 colored photo
4. The CERTIFICATION on page 3 is an integral part of this general application of applicant
form. An application unaccompanied by the Certification will be
summarily denied. All documents submitted to APECO must
conform to the representations in the Certification.
DATE OF ENTRY IN THE PHILIPPINES: Mo. Day Year FILE NO.
VISA/PERMIT APPLIED FOR:
[ ] APECO SPECIAL INVESTOR’S RESIDENT VISA [ ] APECO SPECIAL RESIDENT VISA
(ASIRV) (ASRV)
[ ] APECO WORKING VISA (AWV) [ ] APECO SPECIAL WORK PERMIT (ASWP)
[ ] APECO PROVISIONAL WORK PERMIT (APWP) [ ] APECO DEPENDENT VISA (ADV)
[ ] APECO CERTIFICATE OF EXEMPTION FROM AEP Others, Specify:
AND WORKING VISA (ACE)
PERSONAL DATA
Sex: Female Age
Place of Birth: __________________ Date of Birth: Nationality: ____________________
(Last Name)
(Last Name)
APPLICANT’S RESIDENCE IN THE PHILIPPINES
Address From To
Present Address:
Previous Address:
APPLICANT’S ADDRESS OUTSIDE THE PHILIPPINES:
Address From To
Page 1 of 3
AIU Form No. 001
Series of 2016
Single Divorced/Legally Separated
Place of Birth: __________________ Date of Birth __________________ Citizenship ________________ Age ________
CHILDREN (Unmarried children below twenty-one (21) years of age) as of date of filing of application:
Name Age Place/Date of Birth Sex
Use additional sheet if necessary
APPLICANT’S PREVIOUS EMPLOYMENT: (List present employment first)
Name of Employer/Address Occupation From To
LANGUAGES SPOKEN ASIDE FROM NATIVE LANGUAGE:
1. 2. 3.
Place Issued:
Date Issued:
CHARACTER REFERENCES IN THE PHILIPPINES:
Name
Page 2 of 3
Application/s for:
[ ] APECO SPECIAL INVESTOR’S VISA (ASIV) [ ] APECO SPECIAL RESIDENT VISA (ASRV)
[ ] APECO WORKING VISA (AWV) [ ] APECO SPECIAL WORK PERMIT (ASWP)
[ ] APECO PROVISIONAL WORK PERMIT (APWP) [ ] APECO DEPENDENT’S VISA (ADV)
NAME OF PETITIONING COMPANY: ____________________________________________________________
ADDRESS OF PETITIONER: ____________________________________________________________
____________________________________________________________
Date of Incorporation: ____________________________________________________________
Name of Petitioner’s representative: ____________________________________________________________
Position in the company: ____________________________________________________________
Position to be occupied by alien in the company: _________________________________________________________
Job to be performed by the alien in the company: ________________________________________________________
Primary Purpose of the company: ____________________________________________________________
Alien Employment Permit Number: ___________________________ Valid Until: ______________________
Duration of Employment Contract: ____________________________________________________________
[True Copy of the contract is attached.]
Reason for alien’s employment/engagement: _____________________________________________________________
__________________________________________________________
__________________________________________________________
CERTIFICATION
I hereby certify under oath that all the information in this general application form consisting of three (3) pages, including
the page on which this Certification is written contains true and correct information about myself as an applicant. I further
warrant that I have complied with all the requirements of the Aurora Pacific Economic Zone and Freeport Authority (APECO)
with respect to my application/our petition for , for the change of status
to and that I have submitted duly certified copies of documents
issued under the official seal of the officer having legal custody of their originals in the Philippines, and foreign documents with
their official translation in English duly authenticated by the Consul/Embassy official in the foreign service of the Philippines in
the foreign country, in compliance with the requirements of APECO. I understand that my application can be denied
summarily by APECO if any statement herein is found to be false, if any documentsubmitted is found to have been falsified,
or if I fail to comply with all the requirements of APECO with respect to my application/our petition without prejudice to
whatever recourse APECO shall take in accordance with applicable laws in the Republic of the Philippines.
Date Executed:_____________________
Place Executed:_____________________
________________________________________
___ (Applicant’s/Representative’s Signature over
Printed Name)
CTC/ACR/Passport No.
___________
Place of
Issue:_________________
Date of Issue:_________________
Republic of the Philippines}
_____________________}
S.S.
SUBSCRIBED AND SWORN TO BEFORE ME THIS _______ day of ______________ at
____________________________. AFFIANT EXHIBITING TO ME HIS/HER Passport No.
______________ issued at ________________________ on __________________.
NOTARY PUBLIC
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