1. IMM 5645 â ADDITIONNAL FAMILY INFORMATION
Complete
family name
Relationship Marital Status
Date of birth
(YYYY-MM-
DD)
City and
country of
birth
Current
address (if
deceased:
indicate in
which city,
country or
territory and
the date)
Email address Occupation
EROLD JOHN
R. LACEN
YOU Single 2001-01-02
San Pablo City,
Philippines
Sitio Bagong
Silang, Brgy.
San Nicolas
San Pablo City,
Laguna
eroldjohnramos
@gmail.com
Welder
N/A
Spouse /
Common-law
partner
N/A N/A N/A N/A N/A N/A
Mother
Father
If you have any children:
2. IMM 5645 â ADDITIONNAL FAMILY INFORMATION
If you have brothers, sisters, half-brothers or sisters :