Note Verbale Form

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REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF FOREIGN AFFAIRS


MANILA
Diplomatic and Official Passports Section
REQUEST FOR ISSUANCE OF
NOTE VERBALE/LETTER
( ) Diplomatic
( ) Official

Date of Issue : _________


Valid Until : ______________
___

________

_________
Date

NAME
________________________________________________

______

DESIGNATION/AGENCY
_______________________________________________

DESTINATION
________________________________________________

_____________

PURPOSE OF TRAVEL
____________________________________

___________________

________

DURATION OF TRAVEL
__________________________________________

___________

___________

_______________________
_
Applicant/Authorized Representative
NOTE VERBALE REQUIREMENTS
1. Issuance of Note Verbale/Letter Application Form.
2. Photocopy of Passport.
3. Signed Travel Authority/Request Letter.
4. Photocopy of Confirmed Flight Itinerary (for In-Transit)

(FOR DFA-OCA USE ONLY)

Date

: _________

_________

Processor

: ________

_________

Released by

: _______

_________

____________
_____________
Approving Officer

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