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rd_oath form.pmd - PRC Passers

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Republic Republic Republic of of the the Philippines<br />

Philippines<br />

Professional Professional Regulation Regulation Commission<br />

Commission<br />

Manila<br />

Manila<br />

PANUNUMPA NG PROPESYONAL<br />

Ako, si _____________________________________________________, ng<br />

___________________________________________________________________________<br />

CLAIM SLIP<br />

<strong>PRC</strong> REG Form No. 001 (Rev. Nov 2007)<br />

ay taimtim na nanunumpa na itataguyod ko at ipagtatanggol ang Saligang Batas ng Pilipinas, na<br />

ako ay tunay na mananalig at tatalima rito; na susundin ko ang mga batas, mga utos na legal, at<br />

mga atas na ipinahayag ng mga sadyang itinakdang may kapangyarihan ng Republika ng Pilipinas;<br />

at kusa kong babalikatin ang pananagutang ito, na walang ano mang pasubali o hangaring umiwas.<br />

Taimtim pa rin akong manunumpa na sa lahat ng panahon at pook na kinaroroonan ay<br />

mahigpit akong manghahawakan sa mga etikal at tuntuning propesyonal ng<br />

mga_________________________________ sa Pilipinas, at marapat kong gagampanan ng<br />

(Propesyon)<br />

(Pook na Sinilangan, Bayan/Lungsod, Probinsya)<br />

buong husay sa abot ng aking makakaya ang mga tungkulin at pananagutang iniatang sa isang<br />

itinakdang ____________________.<br />

_______________________________<br />

(Lagda)<br />

A - _______________________ _____________________ ____________________<br />

(Blg. ng Sedula) (Kinuha sa) (Petsa)<br />

Nilagdaan at Pinanumpaan sa harap ko ngayong ika-_________ ng _________________<br />

taon ng ating Panginoon _______________sa _________________________, Pilipinas.<br />

Selyo<br />

Dokumentaryo<br />

Telephone/Contact Number :<br />

Citizenship:<br />

Kasihan Nawa ako ng Diyos.<br />

Civil Status: Sex:<br />

(Propesyon)<br />

PERSONAL DATA<br />

_______________________________<br />

(Pinunong Tagapanumpa)<br />

_______________________________<br />

(Katungkulang Opisyal)<br />

Date of Examination:<br />

Date of Birth:<br />

Spouse’s Name/Citizenship:<br />

Father’s Name/Citizenship: Mother’s Name/Citizenship:<br />

PLEASE FILL OUT THIS CLAIM SLIP<br />

FOR <strong>PRC</strong> PROCESSING<br />

OK to Pay: ___________________________________<br />

OR No.: _____________________________________<br />

Date Paid: ___________________________________<br />

Profession: __________________________________<br />

Registration No.: ______________________________<br />

Registration Date: _____________________________<br />

NAME:______________________________________________ PROFESSION: _________________________________<br />

REGISTRATION NO. __________________________________ REGISTRATION DATE:___________________________<br />

Please present this slip at Issuance Window ______________________ to claim your professional identification ca<strong>rd</strong> on<br />

___________________________.<br />

(NOTE: REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULD PRESENT SPECIAL POWER OF ATTORNEY / AUTHORIZATION<br />

LETTER FROM THE REGISTERED PROFESSIONAL). FOR CONFIRMATION PLEASE CALL UP (02) 736-22-48.<br />

______________________________________________<br />

Registration Officer<br />

Paste here<br />

your recent<br />

PASSPORT SIZE<br />

colored picture in<br />

white background with<br />

complete name tag


Step 1. Accomplish this Oath Form.<br />

PROCEDURES<br />

Step 2. Pay for two sets of metered documentary stamps (one stamped on this <strong>form</strong> and one<br />

for the Registration Certificate) at the Customer Service Center.<br />

Step 3. Present duly accomplished <strong>oath</strong> <strong>form</strong> (where your profession belongs, for verification<br />

of reco<strong>rd</strong>s and assessment at Window 14, Window 19, Window 28 or at <strong>PRC</strong> Service Center,<br />

Ever-Recto<br />

Step 4. Pay prescribed fees at the Cashier.<br />

Step 5. Sign in the Registry Book and receive your claim slip at:<br />

Window 17 Window 20 Window 27<br />

Step 6. Claim your professional ID as scheduled. Please refer to your claim slip for<br />

further instructions.<br />

REQUIREMENTS<br />

1. Duly accomplished Oath Form or Panunumpa ng Propesyonal<br />

2. Current Community Tax Certificate (cedula)<br />

3. Two pieces passport size colored picture in white background with complete name tag<br />

(for Oath Form and Certificate of Registration)<br />

4. One pc. 1”x1” colored picture in white background with complete name tag<br />

(for Registry of Professionals)<br />

5. Two sets of metered documentary stamps (for Oath Form and Certificate of Registration)<br />

6. One (1) short brown envelope with name and profession<br />

New registrants should come personally to the <strong>PRC</strong> Central Office or to the nearest<br />

Regional Office to file his/her application for registration and to affix his/her signature on the<br />

registry book.<br />

In case registrant is located abroad, please find below the following requirements :<br />

1. Take the professional’s <strong>oath</strong> before the Philippine Consul.<br />

2. Special Power of Attorney notarized by the Consul.<br />

3. Copy of passport page showing personal data.<br />

4. Copy of passport page showing date of entry abroad.<br />

Boa<strong>rd</strong> Certificates shall be claimed at the Central Office or the Regional Office where<br />

the application for the same has been filed. Representatives must present Special Power of<br />

Attorney and appropriate identification papers.

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