REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF JUSTICE
BUREAU OF IMMIGRATION
MAGALLANES DRIVE, INTRAMUROS
1002 MANILA

Republic of the Philippines )

City of ________________ )

_________________________
Commissioner
Bureau of Immigration
Magallanes Drive, Intramuros
Manila

Re: Letter of Undertaking to submit

_____ NBI Clearance

_____ Authenticated Police Clearance
_____ Authenticated Birth Certificate
_____ Authenticated Marriage Contract
_____ Authenticated Family Registry
_____ Others
_________________,

Dear Sir:

In connection with my application for a Working Visa under Section 9(G) of C.A. 613, and
pursuant to Operations Order No. SBM-2014-023, “Submission of Letter of Undertaking on Visa
Applications” the undersigned respectfully request acceptance of this Letter of Undertaking in
lieu of the Authenticated Birth Certificates of (1) _________________and (2)
_________________
I have already applied for the issuance of the Authenticated Birth Certificates of (1)
_________________and (2) _________________ and I undertake to submit the same to the
Verification and Compliance Division (VCD) within sixty (60) days from submission of my
application.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _________ day of

______________, 2018 at ______________________.

Respectfully yours,

Mother

SUBSCRIBED AND SWORN to before me this _____ day of _________________ 2018 at

______________________, affiant personally appeared and exhibited to me, as proof of identity
her Passport No. ____________________ issued on ___________________ at
____________________________.

Doc No. ______ Notary Public

Page No. _____
Book No. _____
Series of 2018.