Republic of the Philippines)

Province of Ilocos Sur ) s.c.

Vigan City
)

AFFIDAVIT OF CONSENT AND SUPPORT

I, ________________, of legal age, Filipino, married, and presently residing at

____________________ Ilocos Sur, after being duly sworn to in accordance with law do
hereby depose and say:

1) That I am the mother of _______________ born on __________ in Quezon City;

2) That I am giving my consent for my child to travel abroad to be accompanied by
me, ______________;
3) That I am sponsoring her trip;
4) That I am financially capable to support her stay abroad;
5) That I guarantee that she will not violate any existing laws of her country of
destination; and
6) That I am executing this affidavit in connection with my childs application for
renewal of her passport at the Department of Foreign Affairs for her travel
abroad.

IN WITNESS HEREOF, I hereunto set my signature at ___________ Ilocos Sur,

Philippines, this 18th day of March 2014.

Mother
SUBSCRIBED AND SWORN TO before me this ______ day of _______________ in
Vigan City, Ilocos Sur, affiant exhibiting to me her Philippine Passport No.
_______________ issued by DFA Manila valid until ____________.

Doc No.______
Page No. _____
Book No. _____
Series of 2014