Alien Employment Permit Online Application

Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office IV-A

CERTIFICATE OF EXCLUSION ONLINE APPLICATION

STEP 1: ACCOMPLISH FOREIGN NATIONAL INFORMATION FORM

I. TYPE OF APPLICATION:

NEW

EXTENSION

II. PERSONAL DATA OF FOREIGN NATIONAL

Last Name:

First Name:

Middle Name:

Nationality:

Sex:

Marital Status:

Date of Birth:

Place of Birth:

Address in the Philippines:

Contact Number:

Email Address:

Permanent Address Abroad:

Passport No.:

Valid From:

Valid Until:

Place of Issuance:

Type of Visa:

III. DETAILS OF EXCLUSION/CATEGORY:

Position:

Brief Job Description:

Name of Philippine-based Company:

Business Address:

Company Contact Number:

Company Email Address:

Nature of Business/Industry:

STEP 2: UPLOAD REQUEST and REQUIREMENTS

Clear 2x2 picture taken within 6 months:

Letter request addressed to the DOLE Regional Director:

Photocopy of Valid Passport Biopage with valid visa (except stateless persons):

Certified True Copy (CTC) of either the valid business/Mayor’s permit of the Philippine-based company or Certificate of Registration with the Economic Zone Authorities where the company is located:

PEZA Certificate of Registration or Mayor's/Business Permit No.:

Previously issued Exclusion card:

Type of AEP Accreditation:

Notarized Secretary's certificate and Board Resolution for the authorized Representative:

Reviewing of Application

TYPE OF APPLICATION:
Last Name:
First Name:
Middle Name:
Nationality:
Sex:
Marital Status:
Date of Birth:
Place of Birth:
Address in the Philippines:
Contact Number:
Email Address:
Passport No.:
Valid From:
Valid Until:
Place of Issuance:
Type of Visa:
Visa Validity:
Other Visa Validity:
Exclusion Category:
Position:
Brief Job Description:
Name of Philippine-based Company:
Business Address:
Business Contact Number:
Business Email Address:
Nature of Business/Industry:
Request Form for Certificate of Exclusion:

I hereby certify that all the information provided by me in this application are true and correct to the best of my knowledge. I understand that all the information I provided will form part of the public record, which may be used for any legal processes of the government. Thus, any misrepresentation of facts may subject my application to denial and myself to possible administrative and/or criminal action. I also do understand that incomplete applications would be subject for denial.

By using this application, you agree that the information submitted shall be used solely fro DOLE IV-A processing of application and report monitoring purposes. We may likewise disclosed establishment's or your personal information to the extent that we are required to do so by the Data Privacy Act of 2012. As a general rule, we may only keep your information until such time that we have attained the purpose by which we collect them. Under the foregoing circumstances and to the extent permissible law, you agree not to take any action against DOLE IV-A for the disclosure and retention of your information.