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PRC Renewal Application Guide

This document is an application for a Professional Identification Card (PIC) renewal for Aida C. Dela Cena. It provides her personal details like name, citizenship, birthdate, address and contact information. It also lists her educational background, date of graduation, date of registration, profession and license number. There is a declaration section where she consents to the collection and processing of her personal data. It also notes the appointment date, time and venue for her PIC renewal.

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Noel Dela Cena
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52 views1 page

PRC Renewal Application Guide

This document is an application for a Professional Identification Card (PIC) renewal for Aida C. Dela Cena. It provides her personal details like name, citizenship, birthdate, address and contact information. It also lists her educational background, date of graduation, date of registration, profession and license number. There is a declaration section where she consents to the collection and processing of her personal data. It also notes the appointment date, time and venue for her PIC renewal.

Uploaded by

Noel Dela Cena
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

TIME RECEIVED:

TIME RELEASED:

Professional Regulation Commission

APPLICATION FOR PROFESSIONAL IDENTIFICATION CARD (PIC)

NOT FOR SALE (REPRODUCTION IS ALLOWED)

APPOINTMENT DATE: March 30, 2021 (05:00 PM TO 06:00 PM) - Robinsons Place Pangasinan
REFERENCE NO: RE1QE64PSV6X | OR: - | Amount: PHP -
NAME: DELA CENA, AIDA CEREZO

CITIZENSHIP: FILIPINO BIRTHDATE: January 25, 1969

PERMANENT MAILING ADDRESS: 132/CALOOCAN NORTE


TEL. NO. / CP NO.: 09276437128 EMAIL ADDRESS: aida.delacena001@[Link]
SCHOOL GRADUATED: LYCEUM NORTHWESTERN UNIVERSITY-DAGUPAN CITY DATE GRADUATED: November 27, 1990
REGISTRATION DATE: November 28, 2001 EXPIRATION DATE: January 25, 2024
PROFESSION: PROFESSIONAL TEACHER LICENSE NO.: 0742500

DECLARATION AND ATTESTATION

I am aware and I give my consent to the collection of the data required by this application form and
the taking of my photograph, and if applicable, the taking of my fingerprints.

I further attest that all particulars and supporting documents provided by me are correct and
complete. I am aware that any false statement or fraudulent document will lead to the rejection of my
application or to the cancellation of my PIC already issued, and may also render me liable under applicable
administrative and criminal laws.

SIGNATURE OF LICENSEE

UNDERTAKING

(To be filled up by professionals, except for Real Estate Practitioners, who failed to comply with the
required CPD Credit Units for the renewal of Professional Identification Card)

For this compliance period, I am submitting CPD units of the total required CPD Credit units. I
hereby undertake to submit the balance of CPD credit units in addition to the required CPD units (or a
total of units) for the next renewal of my PIC. I understand that in the event I fail to comply, my PIC will
not be renewed.

SIGNATURE OF LICENSEE

NOTE:
1) ALL REAL ESTATE PRACTITIONERS CANNOT AVAIL THE UNDERTAKING AND HAVE TO
PROVIDE PROOF OF COMPLIANCE WITH CPD PRIOR TO RENEWAL OF PIC PURSUANT TO
SECTION 17, ARTICLE III OF REPUBLIC ACT NO. 9646 OR THE REAL ESTATE SERVICE ACT
OF THE PHILIPPINES AND BOARD RESOLUTION NO. 49, S. 2015.
2) REPRESENTATIVE OF THE PROFESSIONAL APPLYING FOR ISSUANCE OF PROFESSIONAL
IDENTIFICATION CARD (PIC) MUST SUBMIT:
a) THE PRESCRIBED AUTHORIZATION LETTER AND PHOTOCOPY OF PROFESSIONAL
IDENTIFICATION CARD (PIC) OF THE REPRESENTATIVE AND EXPIRED PIC OF THE
PRFESSIONAL; OR
b) SPECIAL POWER OF ATTORNEY (SPA) AND PHOTOCOPY OF ANY VALID GOVERNMENT
ISSUED IDENTIFICATION CARD (ID) OF THE REPRESENTATIVE AND THE PROFESSIONAL
3) STRICTLY FOLLOW THE APPOINTMENT DATE ON RENEWAL OF PROFESSIONAL
IDENTIFICATION CARD (PIC).

REG-03
Rev. 02
September 15, 2017
Page 1 of 1

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