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Online Request For Clearance
 
Please put N/A for each entry that does not apply to you.
* Required fields
 
Purpose of Clearance: *
Processing Fee: P100.00
CDD Qty:
Death Claim Qty:
Disability Retirement Qty:
Discharge Qty:
Dropped from the Roll Qty:
End of Contract (Specify Date) Qty:
End of Term (Specify Date) Qty:
Expiration of Appointment Qty:
Expiration of Term Qty:
GSIS Claims Qty:
Rationalization Qty:
Resignation (Specify Date) Qty:
Retirement (Specify Date) Qty:
Reversion Qty:
Separation (Specify Date) Qty:
TPPD Qty:
 
Processing Fee: P150.00
AppointmentQty: Lateral EntryQty:
ConfirmationQty: PromotionQty:
EmploymentQty: ReappointmentQty:
Foreign AssignmentQty: ReemploymentQty:
Grant of BenefitsQty: TransferQty:
 
Processing Fee: P200.00
Awards (Specify Name) Qty:
Bar Exam Qty:
CES Eligibility Qty:
CESO Rank Qty:
Change of Name (Specify Name) Qty:
Commissionship Qty:
Completion of Residency Training Qty:
Court Requirement Qty:
Extension of Service Qty:
Foreign Travel Qty:
Free and Accepted Masonry Qty:
Guarantorship Qty:
Leave Application Qty:
Loan Application Qty:
Scientific Career System Qty:
Study Grant Qty:
SUC Presidency Qty:
Nomination Qty:
Recognition Qty:
UN Mission Qty:
Visa Qty:
Requirement by JBC, CSC, CESB, Office of the President, PRC, GOCC, DFA, DOLE, BI, LTO, NBI, PNP & other agencies
Please specify agency Qty:
Scholarship Qty:
Schooling Qty:
 
Processing Fee: P500.00
Permit to Carry Firearms Qty:
Fidelity Bond Qty:
Bidding Requirements Qty:
 
Processing Fee: P1,000.00
Firearm License Qty:
 
MODE OF PAYMENT*
LANDBANK soon
SM, Department Store/Business Center (plus: service fee of P50.00 + private courier fee of P150.00) per copy
Cash
Postal Money Order payable to 'Office of the Ombudsman Clearance Fees'
 
MODE OF RELEASE*
Fill this up if you are paying by Cash/PMO. All aplications paid thru SM will be automatically delivered via private courier.
For Cash / PMO payments ONLY:
   For Pick-up
   By private courier (applicant shall provide prepaid envelope)
   By regular mail
 
Central Office: Office of the Ombudsman, OMB Building Agham Road, North Triangle Diliman, Quezon City 1101
OMB Visayas: Office of the Ombudsman for the Visayas, Department of Agriculture RO-7 Compound M. Velez St., Guadalupe, 6000 Cebu City
OMB Mindanao: Office of the Ombudsman for Mindanao, 4th Flr. H&C Bldg., Alvarez St., Sta. Ana, Davao City
 
Jurisdiction *
Applicant‘s mailing address is located in  
 
EMPLOYMENT DETAILS
Last Position Held*:
Name of Office or Company*:
Office Address*:
 
INFORMATION SHEET
 
First Name:*
Middle Name:*
Last Name:*
If Married, Mother's Maiden Surname:
Date of Birth:*
Home Address *:
Civil Status*:     Gender * :
Date of Marriage:
Previous Address:
Contact Nos:
Email*:
  Please enter a valid email.
Delivery Address? * Home Address Office Address
 
EDUCATIONAL BACKGROUND
  School Attended* Date of Attendance* Degrees Earned*
Elementary*
High School*
College / University*
Highest Educational Attainment *:
 
EMPLOYMENT HISTORY
GOVERNMENT HISTORY
Name of Office Address Position Inclusive Dates
 
PRIVATE SECTOR
Name of Office Address
(City/Municipality, Province)
Position Inclusive Dates
 
Have you been criminally and/or administratively charged before any court or administrative body?* Yes No
If yes, state the:
Case No.
Status
 
Name of Requester:
Relation to the deceased, in case of death claim:
 
*I declare under the penalties of perjury that the answers given above are true & correct to best of my knowledge and belief.
Yes (Conforme)
 
* Please enter the text on the image below (case-sensitive) :
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