REFERENCE NO: RE5RXOJIR2C9 | APPOINTMENT DATE: December 12, 2024 - 10:00 AM-11:00 AM
Professional Regulation Commission
APPLICATION FOR RENEWAL OF PROFESSIONAL
IDENTIFICATION CARD (PIC)
APPOINTMENT DATE: December 12, 2024 - 10:00 AM-11:00 AM O.R. NO. / DATE: E2024-12-10125189 - December 10, 2024
PLACE: PRC Lucena TEL NO./CP NO.: 09564768594 / 09564768594
LAST NAME: LAGNITON FIRST NAME: YSRAEL
MIDDLE NAME: PAWIG MAIDEN NAME (if married): N/A
PROFESSION: PROFESSIONAL TEACHER LICENSE NO: 1066339
REGISTRATION DATE: August 03, 2010 EXPIRATION DATE: February 11, 2028
CITIZENSHIP: FILIPINO CIVIL STATUS: MARRIED
BIRTHDATE: February 11, 1988 EMAIL ADDRESS: [email protected]
PERMANENT MAILING ADDRESS: OO3 MAHARLIKA SAN AGUSTIN
CURRENT EMPLOYER (if employed): DEPED-SAN JOSE OFFICE ADDRESS: BRGY. SAN JOSE CITY OF STO.TOMAS
NATIONAL HIGH SCHOOL 301141 BATANGAS
CONFORME:
I agree to the PRC Privacy Notice and give my consent to the collection and processing of my personal data in accordance thereto.
YSRAEL PAWIG LAGNITON
(SIGNATURE OVER PRINTED NAME)
CPD UNDERTAKING:
I hereby undertake to comply with the CPD requirements in the next compliance period.
SIGNATURE OF LICENSEE
Basic Requirements:
1. Proof of system generated signed application form for the renewal of Professional Identification Card (PIC).
2. Certificate of attendance to accredited Continuing Professional Development (CPD) seminars (Annex A) validated through the CPD
Accreditation System (CPDAS), otherwise sign CPD Undertaking.
3. Other documents as may be prescribed by the Professional Regulatory Law of the concerned profession i.e. Certificate of Good
Standing, Surety Bond for Real Estate.
Additional Requirements:
1. For Overseas Filipino Professionals (OFPs), in lieu of CPD Certificates shall submit any of the following:.
a. Overseas Employment Certificate (OEC) from Philippine Overseas Employment Administration (POEA);
b. Passport and working visa or permit (in a foreign country);
c. Contract of Service or Employment Overseas;
d. Company Identification Card (foreign company);
e. Residence permit/permit to stay in a foreign country; or
f. Other credible proof/s of identity or status as OFP
2. A former Filipino professional who has reacquired Philippine citizenship shall submit the following:
a. Certificate of Reacquisition/Retention of Philippine Citizenship (CRPC) issued by the Bureau of Immigration (BI); and
b. Copy of new Oath Form (Panunumpa ng Propesyonal)
3. For professionals with dual citizenship, shall submit any of the following:
a. Proof of Philippine citizenship (i.e. valid Philippine passport);
b. Oath of Allegiance from Philippine Consulate and Identification Certificate of Philippine Citizenship issued by the Bureau of
Immigration; and
c. Certificate of Retention or Re-acquisition issued by Bureau of Immigration
Requirements for Representative:
1. Non-registered professional - any valid government-issued ID and Special Power of Attorney (SPA) duly executed individually by the
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February 15, 2024
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applicant.
2. Registered professional - valid Professional Identification Card/e-PIC and authorization letter duly signed by the concerned applicant.
Procedures:
1. Log in using LERIS account https://online.prc.gov.ph to secure an appointment date and place, and select payment option/channel. If
the client opts for the delivery of printed PRC PIC, select shipping button, input shipping details and select payment options. .
2. Present the proof of system-generated Application Form for the Renewal of PIC and other documentary requirements to the
designated window.
3. Receive the valid PIC and sign on the releasing log sheet.
PRD-27
Rev. 02
February 15, 2024
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