COMMISSION ON FILIPINOS
OVERSEAS
INFORMATION SHEET FOR FILIPINO EMIGRANTS
PHOTO
INSTRUCTIONS : Please PRINT letters in the spaces provided.
Please CHECK ( ) appropriate box(es).
(FOR CFO USE ONLY)
CFO No. / Emigrant No.
OR #
GCC Form #
Issue Date [ mm-dd-yyyy ]
Category
Reg. Date [ mm-dd-yyyy ]
Verifier
PERSONAL
DATA
Last Name
M A N Z O
First Name
WI
N E
Middle Name H E
Suffix
F R E D A
R N A N D E Z
If married, please state mother's maiden name N A
DATE OF BIRTH [ mm-dd-yyyy ]
0 5
0 5
AGE
SEX
5 99
CIVIL STATUS
Male
Female
Single
Divorced
PLACE OF BIRTH
Town / City
Province
Married
Widow(er)
Separated
Outside of the Philippines
N A M A L
R I
E N T A
A Y A N
L
M
M I
N O T
N D O
A P
P L I
C A B L E
R O
ADDRESS & CONTACT NUMBERS IN THE PHILIPPINES
D E L P I L A R, S T.
House No. / Street / Barangay
P I N AM AL AYAN
Town / City
O R
E N T A L
M I N D O R O
Province
Zip Code
N O N E
Telephone Number
2 1
9 3
1 6
Cellphone Number
winefredamanzo@yahoo.com
E-mail Address
ADDRESS & CONTACT NUMBERS (Country of Destination)
1 2
D U L A L A S
L O O P
House No. / Street
Y I
City
G O
G U A M ,
2 9
/ State
U N
T E D
S T A T E S
O F
A M E R I
C A
Country
9 2
Zip Code
Telephone Number
6 5
2
Cellphone Number
PASSPORT NUMBER
E B 1
7 5
DATE OF ISSUE [ mm-dd-yyyy ]
VISA NUMBER
Revised as of January 2008
NOT FOR SALE
DATE OF ISSUE [ mm-dd-yyyy ]
THIS FORM IS
HIGHEST EDUCATIONAL ATTAINMENT
Elementary Level
Elementary Graduate
High School Level
High School Graduate
Vocational Level
Vocational Graduate
College Level
College Graduate
Post Graduate Level
Post Graduate
No Formal Education
Others
Not of schooling age
( Below 7 yrs old )
If vocational / college / post graduate, state course
ECONOMIC STATUS
Employed
Self-employed
Unemployed
If employed / self-employed, state profession / occupation / business
N A
If unemployed, check appropriate box
Housewife
Student
Retiree
Out-of-school youth
Minor (Below 7 yrs old)
Not reporting any occupation
DATA OF NEAREST FAMILY MEMBER IN THE PHILIPPINES
Last Name
M A Z O N
First Name
Middle Name M A N Z
D E L
Suffix
I A N A
O
Relationship S I S T E R
I L A R
S T
House No. / Street / Barangay
N A M A L A Y A N
Town / City
O R
I E N T A L
M I N D O R O
Province
Zip Code
N O N E
Telephone Number
8 2
9 1
Cellphone Number
E-mail Address
PETITIONER'S DATA
Last Name
M A N Z O ,
First Name
F I D E L A
Middle Name
H E R N A N D E Z
Suffix
Relationship
MOTHER
Age
8 0
ADDRESS & CONTACT NUMBERS ABROAD
1 2 0
D U L A L A S
L O O P
House No. / Street
Y I G O , G U A M
City
9 6 9 2 9
/ State
U N I T E D
S T A T E S
O F
A M E R I C A
Country
9 6
9 2
Zip Code
E-mail Address
N O N E
Telephone Number
CITIZENSHIP
Cellphone Number
YEAR OF MIGRATION [ yyyy ]
F I L I P I N O
OCCUPATION
UNEMPLOYED
CERTIFICATION
I hereby certify under penalty of law to the truth and correctness of
the statement and that this form was accomplished by me
personally or under my personal direction.
SIGNATURE ABOVE PRINTED NAME
Revised as of January 2008
THIS FORM IS NOT FOR SALE