Fidelity Bond Application Form Annex D: What It Is and How to Use It

Form 3: Annex D is the Philippines Bureau of the Treasury (BTr) form used to request a new or renewed fidelity bond—or to request cancellation—for an accountable public officer. BTr’s Fidelity Bonding page links the current fillable PDF, but the form itself still shows an unfinished revision placeholder. For applications, follow the current online process and checklist rather than treating a blank PDF as the entire submission.

Get the current Annex D form

Download the BTr-linked fillable Form 3: Annex D from the BTr Fidelity Bonding page. The PDF is two pages and bears the heading “REQUEST FOR APPLICATION FOR BONDING AND/OR CANCELLATION OF FIDELITY BOND OF ACCOUNTABLE PUBLIC OFFICER.” Although BTr links it as the current form as of October 8, 2026, its printed revision field reads “Revision No. xxx Date xxxxx”; that placeholder does not establish a completed revision date.

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The form is Philippines-specific and concerns fidelity bonding for accountable public officers. Use BTr’s live page to check the linked form, requirements, process flow, FAQs, premium-rate information, and circulars before applying.

Choose the correct request type

The form provides choices for a new application, renewal, or cancellation. A cancellation request uses the separate section identified as items 24–32; it is not simply a renewal or a new application with a changed date.

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What the two-page PDF asks for

Page one: applicant information and declarations

The first page asks for identifying and contact details, income and expenses, information about separation from prior employment, administrative or criminal case history, character references, and government-issued ID details. It also requests a 2×2 or passport-size photograph and includes a declaration, signature, and oath. Treat the form as sensitive: it gathers personal, financial, employment, and case-history information, and asks the applicant to attest to the information’s truthfulness.

Page two: position, accountability, and agency certification

The second page records the office or agency, assignment, position or designation, appointment status, and designation or assumption date. It also captures the accountability amount and type—public funds, property, or forms and valuables—the coverage period, and bond or cancellation details.

The page includes a certification and recommendation for the head of agency, plus fields reserved for BTr, including bond amount, premium, and officer completion. Applicants should not assume they must fill in every field; follow the instructions in the current OFBS workflow and leave BTr-only sections to the appropriate office.

How Annex D fits into the current application process

BTr’s current checklist describes a completed, system-generated Fidelity Bond Application Form, signed and subscribed and sworn before an officer authorized to administer oaths or notarized. It also lists a one-time OFBS enrollment form, a system-generated list of bonded accountable public officers, and a passport-size ID picture taken within the preceding three months. The application route described in the BTr Citizens Charter is online through OFBS for accountable public officers in national government agencies, government-owned or controlled corporations (GOCCs), and local government units (LGUs).

1. Use OFBS and follow your agency’s submission route. The Citizens Charter outlines online submission and agency approval before documentary review.
2. Complete the form generated for the application. The checklist refers to a system-generated form, so do not assume that downloading the blank fillable PDF alone completes the current application.
3. Assemble the checklist items for your applicant category. The general documents and any category-specific additions are set out in BTr’s 2026 Fidelity Bond requirements checklist.
4. Follow the current review and payment instructions. The Citizens Charter outlines documentary review, payment after the relevant payment authority, and confirmation. Check the live BTr page and your agency’s instructions for the applicable workflow; the charter’s procedure is tied to that document’s version.

BTr also publishes a Fidelity Bonding process flow. The Citizens Charter provides procedural context, not a guarantee of an individual application’s eligibility, processing time, or payment amount.

Check whether your category needs extra documents

The 2026 checklist names additional documents for several groups, including barangay and Sangguniang Kabataan officials, certain LGU applicants, applicants in governmental organizations, applicants with pending administrative or criminal cases, and special disbursing or collecting officers. Depending on the category, examples include approved budget and inventory materials; incumbency, oath, or appointment records; case pleadings and a notarized undertaking; or an office order specifying a special disbursing or collecting officer’s purpose, duration, and accountability.

These examples are not a universal document list. Check the current BTr checklist entry that matches the applicant’s category, and ask BTr or the responsible agency office for case-specific direction where a pending case is involved. The form’s case-history questions do not, by themselves, establish whether a particular applicant qualifies.

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Blank PDF versus OFBS-generated form

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