PRA: Philippine Retirement Authority

SPECIAL RESIDENT RETIREE'S VISA APPLICATION (Form PRA-RSC-2007-001)

* Required Fields.
Please Check One: *	Principal	Spouse	Dependent below 21	Indicate Principal SRRV ID or Application No: *
Choose SRRV Option *	Without Pension	With Pension		Indicate Principal SRRV ID or Application No: *
Applying From *	The Philippines	Outside the Philippines

Address in Home Country (No Post Office Box or Hotel please) *

Telephone *

Mobile

Fax

Gender *
Male Female

Date of Birth *

Place of Birth *

Religion

Civil Status *
Single Married Separated Widow

Height (in cm)

Weight (in kg)

Name of Spouse (Last, First Middle)

Spouse SRRV Application No.

Contact Information in the Philippines

Address in the PHILIPPINES (No Post Office Box or Hotel please)

Telephone	Mobile	Fax

Please write NA if not applicable

Degrees Obtained
Undergraduate * School *	Post Graduate School

Present or Former Occupation or Business *	Field of Expertise *

Last, First, Middle Name of Children below 21 years old	SRRV Application No.
Add more child
1.	1.

Check a box if you have an existing business in the Philipines or have plans to set up one *
Fill in below if you checked 1 or 2 :

1.Have set up

2.Plan to set up

3.None

Upload Picture in .jpg or .gif only (Passport size photo taken not more than 6 mos. ago.) *

PRA Head Office
29/F Citibank Tower, Paseo de Roxas, Makati City, 1227 Philippines

Upload required documents: :

Required Documents

Original documents must be presented to PRA office upon arrival to the Philippines. All applicants below 35 years old shall not be accepted.

Passport
Marriage Contract (Below are alternative requirements in lieu of the Marriage Certificate)
- Family Register/Domicile (for Koreans & Japanese)
- Household Register (for Taiwanese)
- Certificate of Relationship (for P.R.O.C. Chinese)
- Koseki Tohon (for Japanese)
- Birth certificate for minor child.
Medical Examination Clearance duly authenticated by the Philippine Embassy or Consular Office (If secured abroad, with English translation)
Police Clearance secured from the country of origin, duly authenticated by the Philippine Embassy or Consular Office (with English translation)
Proof of Dollar Remittance to any PRA Accredited Banks
For those who selected the "With Pension" option, Certification of Retirement Benefits issued by the concerned government and/or private entity authenticated by the Philippine Embassy or Consular Office is needed.