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Republic of the Philippines
Office of the President of the Republic of the Philippines

NATIONAL COMMISSION OF SENIOR CITIZENS

9200-000000000

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ONLINE SENIOR CITIZEN DATA FORM

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Please fill up completely and correctly the required information before each item below.  For items that are not associated to you, leave it blank.  Required items are also marked with an asterisk (*) so please fill it up correctly.  Your honest response will help the National Commission of Senior Citizens (NCSC) come up with a good information system of the senior citizens in the country as the basis of designing its programs and activities that will help improve the lives of Filipino older persons.

* Items with an asterisk (*) are required.

I.  IDENTIFYING INFORMATION

NOTICE: Do not include special characters like this *(!@$%^&, etc. in your name entry.  This will create an issue in the record during verification.  Extensions like SR. or JR., etc. must be entered separately by checking on the box provided below.

1.  Name  - Enter your name correctly

How do you type Ñ in your phone or laptop?  Click here!

Using your phone

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  1. Hold the N/n key and the letter n with different accent marks will pop up.

  2. Slide to choose Ñ/ñ.

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If Ñ/ñ doesn’t appear when you long press the N/n key, check your keyboard settings. If the language of your keyboard is set to English, enable Filipino or Spanish too. This should make Ñ/ñ available as an option when you hold the N/n key.

Using your Computer or Laptop

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If your keyboard has a numeric keypad, you can type Ñ/ñ by following these steps:

  1. Enable the numeric keypad by turning on the Num lock key.

  2. Hold the Alt key then type 164 on the numeric keypad to create a lowercase ñ. For the uppercase Ñ, hold the Alt key then type 165.

Note that this would only work if your computer / laptop has a numeric keypad located on the right side of the keyboard.

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To easily remember, here are the keyboard shortcuts:

  • ñ - Alt + 164

  • Ñ - Alt + 165

2. Address - Select region first, and then province, then city, and finally your barangay

...

3. Birth Date - Indicate your birth date correctly

Click here to check for your age.

II.  FAMILY COMPOSITION

21.  Name of your spouse

22. Name of your father

23.  Name of your mother

24.  Name of your child(ren) - If applicable, enumerate the first five and arrange them from oldest to youngest

24.a  Other Dependents - If applicable, specify your dependents below.  Dependents are those living with you

III.  DEPENDENCY PROFILE

25.  Living Condition (Check all applicable)

26.  Living Condition (Check all applicable)

IV.  EDUCATION / HR PROFILE

27.  Highest Educational
        Attainment

28.  Specialization / Technical Skills (Check all applicable)

29.  Shared Skills (Community Service)

30.  Involvement in Community Activities (Check all applicable)

V.  ECONOMIC PROFILE

31. Source of Income and Assistance (Check all applicable)

32.A Assets: Real and Immovable Properties (Check all applicable)

32.B Assets: Personal and Movable Properties

33.  Monthly Income (in Philippine Peso)
This item is optional

34.  Problems / Needs Commonly Encountered (Check all applicable)

VI.  HEALTH PROFILE

35.a   Medical Concern

35.b   Dental Concern

Health Problems / Ailments

35.c   Visual Concern

35.d   Aural/Hearing Condition

35.e   Social / Emotional

35.f   Area of Difficulty

36. List of Medicines for Maintenance  (Type all your maintenance medicines.  Example : Amlodiphne 10mg, Losartan 50mg, etc.)

37.   Do you have a scheduled medical/physical check-up?

37.A    If Yes, when is it done?

  O S C A  I D  A N D   P H O T O   A T T A C H M E N T

ATTACH IMAGE OF YOUR OSCA ID*

* Office of Senior Citizens Affairs (OSCA) ID is required

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Please take an image or picture of your OSCA-ID or any valid government ID.
To attach the image file, take a picture of your OSCA ID and then click on the "Upload your ID" button to locate the image file from your local drive or mobile.  If you don't have an OSCA ID then you can attach any valid ID you have in your possesion.

This attachment item is required.  Please make sure that the name of the registrant matches with the name indicated in the attached ID.

Upload/take image of your ID
Image must not exceed 50MB

WARNING:  DO NOT ATTACH AN INVALID ID AS IT MAY ALSO INVALIDATE THE REGISTRATION.

ATTACH YOUR LATEST PHOTO

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Take a selfie or an actual picture of your face using a camera or your mobile phone.  After the photo has been taken, click on the "Upload" button and locate the image from your local storage or device to attach.  We need a close-up image of your face, so please take an approximately 2x2 size photo capture. 

Do not attach a whole-body picture or your younger-year photo. We only need the actual photo of the face.

Upload/Take your photo
Image must not exceed 50MB

P A S S    K E Y   N U M B E R

Create your own Pass Key Number * (PKN)
Please create your own PKN for your registration below.  You will need this to access and verify your record later.  The maximum combination for the nominated PKN is four (4) digits only.  Make sure to remember and take note of your PKN prior to the submission of the form.

Warning to encoders, do not use the same PKN for all your encoding works.

Click here to show your PKN

A F F I X   Y O U R   S I G N A T U R E

Please affix your signature
Please sign in the space provided below.  If you are using a desktop computer or a laptop, use your mouse to sign by pointing to the space below, left-click and hold, and draw your signature.  If you are using a mobile device, use your fingertip to draw your signature.  You can change your signature by clicking on the "Clear" action button in the right-bottom corner of the space provided and drawing your signature again.  You can proceed after you become satisfied with your signature.

(If the applicant is unable to sign, just proceed and leave the signature blank)

CONFIRMATION TO ALLOW THE STORAGE AND USE OF MY PERSONAL DATA

This is to certify that

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CHECK YOUR ENTRIES!
Scroll down below and check your entries before you submit.

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Complete Name

NAME

Address

Address

Residence

Date of Birth

Birthday

Sex at Birth

Gender

Marital Status

Marital Status

Contact No.

Contact No.

Email

Email Address

Blood Type

Blood Type

PKN

My Signature

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WARNING:
CHECK ALL YOUR ENTRIES BEFORE YOU SUBMIT THEM.  EDITING THE DATA IS COMPLICATED AS IT DEMANDS RIGOROUS TIME TO CORRECT.

I-check muna lahat ng pangalan, address, birthday, at iba pang inpormasyon kung tama bago mag submit. 
Hindi na po mababago ang record kung naisubmit na.
Kung may mali sa naisubmit mo, kailangan sumulat sa registration@ncsc.gov.ph at magbigay ng pagkakakilanlan bago ma update ang iyong record.  Mahirap gawin ito kaya iwasan ang pagsubmit ng mali mali! 

WARNING TO ALL ENCODERS! 
Make sure to encode all the information correctly.  Any mistake may invalidate the registration of the data subject.

Are you sure that the record is correct and ready for submission?

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Due to a high volume of submissions, the registration processing time is longer than usual, or may experience intermittent connection issues. Just keep on retrying until the processing pushes through. We appreciate your patience.

Congratulations!

You have successfully submitted your application for registration.

Name

Registration Reference Number (RRN)

5675564

Please take note and keep your registration reference number or RRN as shown above.
You will use this number to check and verify the status of your registration later. 
It would be best if you can take a picture of it for your safekeeping.

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