The Personal History Statement Form is a comprehensive document designed to gather detailed information about an individual's background. It serves various purposes, from employment processes to official record-keeping, requiring applicants to provide personal data, family details, and other relevant information. Applicants must fill in their full name, including any Chinese Fokien/Mandarin equivalents, and provide specifics about their date and place of birth, physical characteristics, citizenship details, and marital status. The form goes further to ask about the applicant's parents, children, and siblings, ensuring a full spectrum of personal history is covered. Language proficiency, character and credit references, as well as details of an authorized representative, are also included sections, highlighting the form's thoroughness in capturing an individual's personal and social footprint. Ensuring accuracy and truthfulness in filling out the form is crucial, as any deliberate omission or distortion of facts could lead to the disapproval of the application, underscoring the document's role in various verification processes. By signing the form, the applicant certifies the correctness of the information provided, which is then validated through a formal oath-taking process before a notary public, making it an official and legally binding document.
| Question | Answer |
|---|---|
| Form Name | Personal History Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | personal history statement form pnp download, phs form coast guard ph, personal history statement form afp, personal history statement form philippine army |
PERSONAL HISTORY STATEMENT FORM
DIRECTIONS:
1.PRINT all information clearly and completely. Write “NA” if question is not applicable.
2.Use additional sheets for extra details if space provided is not sufficient.
3.The correctness of all statements made will be verified. Any delibirate omission Or distortion of facts will be sufficient cause for the disapproval of application.
PHOTO
2 x 2
PERSONAL DATA |
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Surname |
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First Name |
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Middle Name |
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If Chinese, Fokien/Mandarin equivalent: |
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Surname |
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First Name |
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Middle Name |
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Date of Birth: |
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Place of Birth |
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Sex: |
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Height: |
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Weight: |
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Build: |
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Eyes: |
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Hair:__________ |
Complexion: ______________________ Visible marks or tattoos: |
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Citizenship |
: _____________________ |
How acquired |
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Status |
: _____________________ |
Religion |
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Passport No. |
: ______________________ |
Place Issued |
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Date Issued |
: ______________________ |
Expiry Date |
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Language Spoken |
: 1)_____________________ 2)______________ 3) |
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If married, name of spouse :
Address in Home |
: _______________________________ Tel. |
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Country |
_______________________________ |
No/s. |
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Address in the |
: _______________________________ |
Tel. |
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Philippines |
_______________________________ |
No/s. |
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Parents : ___________________________________ |
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Full Name of Father |
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Full Name of Mother |
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Address of Parents |
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Names and Ages of Children below 21 years of Age :
NAME |
AGE |
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NAME |
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AGE1. |
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1._____________________________ |
_____ |
4. ________________________ |
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2. _____________________________ |
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5. |
________________________ |
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3. ____________________________ |
_____ |
6. |
________________________ |
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Brothers and Sisters and their Ages & Addresses (indicate relationship)
NAME/ADDRESS |
AGE |
RELATIONSHIP |
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OCCUPATION |
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1. _________________________ |
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________________ |
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____________________________ |
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____________________________ |
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2. _________________________ |
_____ |
________________ |
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____________________________ |
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____________________________ |
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3. _________________________ |
_____ |
_________________ |
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____________________________ |
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____________________________ |
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Language Spoken |
: 1) ________________ 2)__________________ 3) |
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CHARACTER AND CREDIT REFERENCES IN THE PHILIPPINES: |
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NAME |
ADDRESS |
OCCUPATION |
1.___________________________ ___________________________
___________________________
___________________________
2.___________________________ ___________________________
___________________________
___________________________
3.___________________________ ___________________________
___________________________
___________________________
APPLICANT’S AUTHORIZED REPRESENTATIVE (S):
NAME |
ADDRESS |
1.________________________________
2.________________________________
I CERTIFY THAT THE AFOREGOING ANSWERS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, BELIEF AND ABILITY.
Signed at ____________________________________ Date
Print Name and Signature of Applicant
SUBSCRIBED AND SWORN TO BEFORE ME this ____ day of _______________ 20___ at
___________________________, AFFIANT EXHIBITING HIS COMMUNITY TAX
CERTIFICATE/PASSPORT NO. _________________ ISSUED AT ___________________
ON ____________________, 20_____.
NOTARY PUBLIC
DOC. NO. ______
BOOK NO. ______
PAGE NO. ______
Series of 20_______