IBP-CCC ID e-REQUEST FORM

IBP ID e-REQUEST FORM

Integrated Bar of the Philippines
CEBU CITY CHAPTER

Please fill-out the request form in CAPITAL letters.

COMPLETE NAME*

FIRST NAMEMIDDLE NAMESURNAME

ATTORNEY'S ROLL NUMBER*

LIFETIME MEMBER/IBP NUMBER*

GENDER*

FM

CIVIL STATUS*

AGE*

DATE OF BIRTH*

Date

PLACE OF BIRTH*

City/Municipality, Province

COMPLETE RESIDENCE ADDRESS*

House or Unit No., Floor, Building

Street, Barangay

CityProvince

Postal / Zip Code

COMPLETE OFFICE ADDRESS*

Unit No., Floor, Building

Street, Barangay

CityProvince

Postal / Zip Code

MOBILE NUMBER*

LANDLINE NUMBER*

EMAIL ADDRESS*

example@example.com

CONTACT PERSON/CONTACT NUMBER IN CASE OF EMERGENCY*

Last Name, First Name, M.I.Mobile Number

ID PHOTO*

Kindly upload a 2x2 photo of you in your business attire and in .jpg or .png image file format

ELECTRONIC SIGNATURE*

Please sign on the blank provided.

DEPOSIT/PAYMENT/TRANSFER TRANSACTION SLIP*

Deposit the amount of P150.00 to [Account Name:I BP-Cebu City/Bank:BDO/Account No: 002938003954] and upload your deposit/payment/transfer transaction slip.

PICKUP/DELIVERY OPTIONS*

Pick-upGrab/Lalamove

AUTHORIZATION LETTER (FOR PICK-UP)

In case you cannot personally pick-up your IBP ID and is sending your representative, please upload your authorization letter. You will be notified when your IBP ID is available for pickup. You may pick-up your IBP-ID at the IBP-CCC Office at IBP Building, Capitol Compound, Capitol, Cebu City during office hours.

PREFERRED DELIVERY ADDRESS*

Residence Address Provided AboveOffice Address Provided Above

AUTHORIZATION FOR DELIVERY BY COURIER: I hereby authorize the IBP-CCC to deliver the requested IBP ID to my preferred delivery address. I also undertake to pay the courier fee upon delivery of my IBP ID.

I agree

WAIVER. In compliance with the requirements of the Data Privacy Act, I authorize the general use of information obtained from me in the course of this undertaking as may be deemed necessary by the Integrated Bar of the Philippines-Cebu City Chapter ("IBP-CCC"). The data, which includes my personal information may be collected, processed, stored, updated or disclosed by the IBP-CCC or continually be collected, stored, processed and/or shared for five (5) years from the conclusion of this undertaking with IBP-CCC or until the expiration of the retention limits set by applicable law, whichever comes later, for legitimate purposes and/or in compliance with any reportorial requirements.*

I Agree

Note: After clicking the "Submit" button, you will be prompted to EMAIL PDF or SAVE PDF. You will be notified when your IBP ID will be available for pickup/delivery. For inquiries, you may contact our secretariat via email tsgc0318@gmail.com or call (032) 2536713. Together with your IBP ID, your IBP-CCC will be giving you an IBP pin, an IBP Sticker, and a car sticker for FREE.