Scribd
Upload
5K views1 page

OSCA Form No. 1 SCID Registration

This document is a registration form for a senior citizen ID from the City Mayor's Office of Davao City, Philippines. It requests information such as the applicant's name, date of birth, address, emergency contact, and status as a senior citizen association member, retiree, or government pensioner. It outlines the requirements for application as proof of age like a birth certificate, proof of residency like a barangay certification, and 2 ID photos. It has spaces for the applicant and local officials to sign off on verifying the information and releasing the senior citizen ID.

Uploaded by

Kimberly Legion
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
5K views1 page

OSCA Form No. 1 SCID Registration

This document is a registration form for a senior citizen ID from the City Mayor's Office of Davao City, Philippines. It requests information such as the applicant's name, date of birth, address, emergency contact, and status as a senior citizen association member, retiree, or government pensioner. It outlines the requirements for application as proof of age like a birth certificate, proof of residency like a barangay certification, and 2 ID photos. It has spaces for the applicant and local officials to sign off on verifying the information and releasing the senior citizen ID.

Uploaded by

Kimberly Legion
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

OSCA FORM NO. 1 CMO.OSCA.F.001 REV.

00 16 MAY 2022
Series of 2022

REPUBLIC OF THE PHILIPPINES


CITY MAYOR’S OFFICE
OFFICE FOR SENIOR CITIZENS AFFAIRS Requirements:
MAIN OFFICE 1. Proof of Age: Any of the ff:
Agton Street, Toril, Davao City, Davao Del Sur Birth/Baptismal Certificate or Gov’t issued ID
(OSCA bldg.) Tel. No.: 272 4029 w/Birthdate/Mailing address
(CSWDO bldg.) Tel. No.: 241-1000 Loc. 394-395 2. Proof of Residency: Barangay Certification
w/inclusion of Date of Birth.
CITY OF DAVAO 3. 2 PCS 1”x1” ID Picture (w/Collar)
SENIOR CITIZEN ID REGISTRATION FORM For Replacement:
Revised 2022 Barangay Certification (If applicable)

FOR ONLINE APPLICATION VIA EMAIL ADD.:


Control #: _________________ (District I) [email protected]
Date: _____________________ (District II) [email protected]
(District III) [email protected]

Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "N/A".
NAME:

Given Name Middle Name Surname


mm-dd-yyyy
Date of Birth: Age: Gender: Civil Status:

Place of Birth: Contact #:

Complete Address:

Barangay: District:

In Case of Emergency Please Notify: Senior Citizen is a social pensioner


Senior Citizen is retiree
Name: __________________________________ City Government annual financial assistance
beneficiary (1,500)
Contact No.: _____________________________ Fully vaccinated
Validated (SafeDavaoQR)
Relationship: ____________________________
Name of Senior Citizen Assn.:________________________
Name of Chapter Pres.: ____________________________

Applicant Approved for Release Released by:


Signature over printed Name LUIS R. MORAN Signature Over printed Name
OSCA HEAD
(This part is to be filled up by the OSCA)
New Rep
Date Verified: PICTURE ID
Claimant’s Signature over Printed Name Verified by: 1”x1”
Contact No.: Name
Validator:
Date: ID NO.:
Name

I hereby authorize the Office for Senior Citizens’ Affairs (OSCA) to collect and process the above information for the purpose of Senior
Citizens’ ID Application. I understand that my personal information is protected by R.A. 10173, Data Privacy Act of 2012.

______________________________________________________
Name and Signature of Senior Citizen / Authorized Representative

You might also like