Form No. 391 (Rev. 2001)
Application for Postal I.D. Republic of the Philippines The The Post Postma mast ster er
PHIL PHILIP IPPI PINE NE POST POSTAL AL COR CORPORA PORATI TION ON
____ ______ ____ ____ ____ ____ ____ ____ ____ ____ ____ ___ _ Date
Sir/Madam I have the honor to apply for a Postal I.D. Attached are four (4) identical copies of my picture (2"x2") and One Hundred Hundred Fifty Pesos for the fee therefore. My personal circumstances are as follows:
Surname
First Name
Occupation ___________________ ___________________________ ________
Middle Name Nationality ____________________
Residence _____________________ ___________________________________________ _____________________________________ _______________ Place of Birth Date of Birth ______________________ _________________________ ___ Hair Color:_____________ Color:_______________________ __________ Height ______________ Eyes ____________ ____________
Complexion ___________________
Distinguishing marks ____________________ ______________________ __ ______________________ ____________________________ ______ __________________________________________ ____________________ ____________________________________________ _________________________ ___ Witness to Thumbmark 1. _____________________ _____________________________ ________
________________________________________
2. _____________________________
Applicant's Signature
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Statement of Issuing Postmaster I hereby certify that I have this _______ day of _____________________ ______________________, _, 20 ______ issued Postal Identification Card No. ___________________ on the foregoing application strictly in accordance with Sections 733-737 of the Postal Manual of the Philippines. The applicant exhibited to me his/her Community Tax Certificate No. _____________________ issued at ___________________ on _________________________ . No Community Tax Certificate because _________________________________________ _____________________________________________ ____ . Cross out words not applicable Application fee paid under Official Receipt No. ___________
Postmaster's Signature ______________________________
Dated _____________________
Printed Name ______________________________________
Post Office of ______________________________________ ______________________________________ -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Support Affidavit of Witness I, ___________________________________ ___________________________________ solemnly swear that I have known M ______________________________________ ______________________________________ _____________________ ___________________ __ , whose picture appears below, personally for _______ years and I know him/her to be the person who made the foregoing application, and that his/her personal circumstances as stated above are true to the best of my knowledge and belief.
Signature _____________________ ________________________________________ ___________________ Position/Occupation of Witness
Printed Name _____________________________________ Post Office of _____________________________________
Name of Office Subscribed and sworn to before me this _______ day of _____________________ ____________________________ _______ 20 ____ at the City/Municipality of _________________________________________ ___________________ ______________________ . The affiant exhibited to me his/her Community Tax Certificate No. _____________________ issued at _____________________ ______________________________ _________ , _____________________ ___________________________________________ ______________________ on _______________________ , 20 No Community Tax Certificate because ______________________ ____________________________________________ _____________________________________________ _____________________________________ ______________ . Cross out words not applicable _________________________________________________ Signature of authorized Officer Documentary Stamp
_________________________________________________ Printed Name _________________________________________________ Title of Officer
