Supplement for Dependent Retention/Re-acquisition of Philippine Citizenship



I, ________________________________________________________________, _ years of age, a citizen of ___________________________ and a resident of ____________________________________________ with contact number _____, after being sworn to in accordance with law, hereby declare under oath that:

  1. I am the petitioner in the above Petition for Retention/Re-acquisition of Philippine Citizenship under Republic Act No. 9225;
  2. I am including in my petition my unmarried child below eighteen (18) years of age pursuant to Section 4 of R.A. 9225, to wit:

Name :_______________________________________________________________________________________________
[as appearing in the Birth Certificate]
Also known as:______________________________________________________________________________________
[as appearing in the foreign passport]
Date of Birth: ________________________ Age: ______________________ Gender: ______________________
Place of Birth: ______________________________ Civil Status: __________________________________________
Nationality: _________________________________ Valid Passport No.: _________________________________
Date of Issuance: __________________________ Place of Issuance: ___________________________________
Father’s Name: ______________________________________________________________________________________
Mother’s Name: _____________________________________________________________________________________

  1. I surrender for cancellation his/her original Alien Certificate of Registration (ACR)
    No. ___________ and Immigrant Certificate of Residence/ Certificate of Residence for
    Temporary Visitors (ICR/CRTV) No. ______________________________.


__________________________________________________
(Signature over Printed Name of the Petitioner)