List of Affidavits

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List of Affidavits Affidavit for Change of Body Type of Motor Vehicle Affidavit of Change Color Affidavit of Denial Affidavit of Desistance Affidavit of Discrepancy of Surname Affidavit of Heirship Affidavit of Identity Affidavit of Illegitimacy Affidavit of Legitimation Sample 1 Sample 2 Affidavit of Loss ATM Card Driver's License OR/CR of Motor Vehicle Passbook Pawn Ticket/Receipt Affidavit of Marital Consent Affidavit of Ownership Affidavit of Parental Consent to Marriage Affidavit of Service Affidavit of Single Status Affidavit of Support and Consent to Travel Affidavit to Use Surname of the Father Affidavit of Two Disinterested Persons Affidavit of Witness

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List of Affidavits

Transcript of List of Affidavits

Page 1: List of Affidavits

List of Affidavits

Affidavit for Change of Body Type of Motor VehicleAffidavit of Change ColorAffidavit of DenialAffidavit of DesistanceAffidavit of Discrepancy of SurnameAffidavit of HeirshipAffidavit of IdentityAffidavit of IllegitimacyAffidavit of Legitimation        Sample 1        Sample 2Affidavit of Loss       ATM Card       Driver's License       OR/CR of Motor Vehicle       Passbook       Pawn Ticket/ReceiptAffidavit of Marital ConsentAffidavit of OwnershipAffidavit of Parental Consent to MarriageAffidavit of ServiceAffidavit of Single StatusAffidavit of Support and Consent to TravelAffidavit to Use Surname of the FatherAffidavit of Two Disinterested PersonsAffidavit of Witness

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REPUBLIC OF THE PHILIPPINES)CITY OF PASAY                ) S.S.x------------------------------------x  

AFFIDAVIT FOR CHANGE OF BODYOF MOTOR VEHICLE

 I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I am the registered owner of a motor vehicle which is particularly described as follows:                 Make & Type :  ______________             Motor Number : ______________             Chassis Number : ____________             Plate Number : ______________             MV File No. : ________________             Year Model :_________________

         Color : _____________________

2. The original body type of the said motor vehicle was "_____________";

3. To have more use of the said vehicle in my business, I have decided to change the body type of the said vehicle from "_____________" to "_____________";

4. The change of body type is not intended for any illegal or unlawful purpose but solely due to the foregoing reasons;

5. I am executing this Affidavit to attest to the truth of the foregoing and in support ofthe application for the change of body type of the above-described motor vehicle on its Certificate of Registration.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Pasay City, Metro Manila, Philippines.

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____________________Affiant

SSS ID No. _____________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence of identity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

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REPUBLIC OF THE PHILIPPINES)CITY OF PASAY                ) S.S.x------------------------------------x  

AFFIDAVIT OF CHANGE COLOR

 I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I am the registered owner of a motor vehicle which is particularly described as follows:                 Make & Type :  ______________             Motor Number : ______________             Chassis Number : ____________             Plate Number : ______________             MV File No. : ________________             Year Model :_________________

         Color : _____________________

2. The original color of the said motor vehicle was "_____________";

3. When the paint of the above-described motor vehicle had faded, I had its color repainted to "_________" such that the color of the said motor vehicle was changed from "_________" to "________";

4. Said change of color is not intended for any illegal or unlawful purpose but solely due to the foregoing reasons;

5. I am executing this Affidavit to attest to the truth of the foregoing and in support ofthe application for the change of color of the above-described motor vehicle on itsCertificate of Registration.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Pasay City, Metro Manila, Philippines.

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____________________Affiant

SSS ID No. _____________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence of identity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

EPUBLIC OF THE PHILIPPINES)CITY OF MAKATI                       ) S.S.

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x-------------------------------------x  

AFFIDAVIT OF DENIAL

I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state:

1. That I was born on ________________ in __________________________;

2. That I established my permanent residence in __________________, Philippines;

3. That on ___________________, I applied for a Record Clearance from the National Bureau of Investigation;

4. That I received an information from the National Bureau of Investigation on ______________ that my namesake, a certain _______________________, has a pending criminal case for Attempted Homicide docketed as Criminal Case No. 1234 pending before Branch 67 of the Metropolitan Trial Court of Quezon City;

5. That I hereby unequivocally deny involvement in the aforementioned case;

6. That I also declare under oath that I am not in any way involved in any case proceeding as either plaintiff/complainant or defendant/accused in the Philippines and abroad, specifically with regard to the aforementioned case;

7. That I have been employed or residing in Hong Kong for ________ years to this date;

8.That ___________________________________________________ (cite other proof/s or reason/s to substantiate your claim that you are not involved in the aforementioned case/s, if any); and

9. That I am executing this Affidavit to attest to the foregoing facts and to denyabsolutely and entirely any involvement in the case/s aforementioned and for all legal intents and purposes.

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IN WITNESS WHEREOF, I hereby affixed my signature this ___________________ in Makati City, Metro Manila, Philippines.

____________________Affiant

SUBCRIBED AND SWORN TO before me this _____________ in ______________, Philippines, affiant exhibiting to me his/her competent evidence ofidentity by way of ______________ issued at _____________ on ______________.     Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

Republic of the PhilippinesDepartment of Justice

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National Prosecution ServiceOFFICE OF THE CITY PROSECUTOR

Makati City

AFFIDAVIT OF DESISTANCE

  WE, FERDINAND M. CASTRO and ROWENA A. CASTRO, Filipinos, of legal ages, husband and wife, respectively, and residents of 106 Sisa Street, Sampaloc, Manila after having been duly sworn to in accordance with law, depose and state:

1. We are the private complainant in a criminal case for Reckless Imprudence Resulting to Damage to Property against Joel O. Castillo docketed as IS No. XV-05-INV-10G-01000 before the Office of the City Prosecutor, Makati City

2.  In this regard, the accused has already paid the damage to our vehicle;

3. In view of the payment by the accused and considering that Rowena A. Castro was not injured, we would like to manifest that we now completely and absolutely exonerate the accused from any liability in connection with the above-mentioned criminal case and that we are no longer interested, and we hereby desist, in prosecuting the said criminal case;

4. As such, we respectfully pray that the aforementioned case against Joel O. Castillo be withdrawn and/or dismissed.

IN WITNESS WHEREOF, we have hereunto set our hands this ___________________ in _______________, Philippines.

  

FERDINAND M. CASTROAffiant

Philippine Passport  No. _____Issued at: ________________Issued on: ________________

ROWENA A. CASTROAffiant

Philippine Passport  No. _____Issued at: ________________ Issued on: _______________

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 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiants exhibiting to me their valid proofs of identification.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

REPUBLIC OF THE PHILIPPINES)

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CITY OF MAKATI            ) S.S.x----------------------------x  

AFFIDAVIT OF DISCREPANCY

 I, SAM L. MILBY, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I was born on 15th day of the October 1960 to spouses Anna Lerma and John Milby;

2. I have been using the name SAM L. MILBY  in all my documents and transactions;

3. However, when I obtained a copy of my birth certificate, I discovered that mysurname appearing thereon was erroneously written as "MELBY";

4. The names “SAM L. MILBY” and “SAM L. MELBY” refers to one and the same person;

5. I execute this Affidavit of Discrepancy of Surname to attest to the truth of the foregoing facts and to explain the discrepancy in my birth certificate with regards my surname.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Makati City, Metro Manila, Philippines.

____________________Affiant

SSS ID No. _____________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence ofidentity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;Page No. _____;Book No. _____;

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Series of 2013.

REPUBLIC OF THE PHILIPPINES)CITY/MUN. OF _____________ ) S.S.x-----------------------------------x

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AFFIDAVIT OF HEIRSHIP

      WE, ________________________, ______________________, ____________________, and ____________________, all of legal age, Filipinos and residents of ________________________________, after being duly sworn to in accordance with law, depose and state THAT:

1. We are the surviving children of  _____________________ who who died on _______________ in ________________ and his deceased spouse __________________;

2. That our parents were survived by the following children/heirs: 

        Full Names of Children/Heirs      Dates of Birth

1. ______________________ ___________________ 2. ______________________ ___________________ 3. ______________________ ___________________ 4. ______________________ ___________________ 

3. As evidence of our legal relation to the deceased, photocopies of our birth certificatesare herein attached; and 

4. We are executing this affidavit in good faith to attest to truth that there is no other heir or heirs except for the above-named heirs of the said deceased spouses and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this ___________________ in Makati City, Metro Manila, Philippines.

____________________Affiant

SSS ID No. _____________

____________________

____________________Affiant

SSS ID No. _____________

____________________

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AffiantSSS ID No. _____________

AffiantSSS ID No. _____________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiants exhibiting to me their SSS Identification Cards as Competent Evidence of Identity (CEI).

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

REPUBLIC OF THE PHILIPPINES)CITY OF MAKATI                      ) S.S.x-------------------------------------x  

AFFIDAVIT OF ILLEGITIMACY

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         I, MARIA B. DELA CRUZ, of legal age, Filipino, single and a resident of 2222 Washington Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law, depose and state:

1. That I am a the mother of Juan Dela Cruz who was born in Davao City on October 5, 2006 as evidenced by the attached Birth Certificate issued by the local civil registrar of Davao City;

2. That my son Juan Dela Cruz was born out of wedlock;

3. That I am not legally married to his father who I no longer have any contact with;

4. That  I am executing this affidavit to attest to the above facts and to confirm the illegitimate status of my child;

5. That I am further executing this affidavit to comply with the regulations of thePhilippine authorities in connection with his travel to Japan and for all legal purposes and intents beneficial to my child.

         IN WITNESS WHEREOF, I have hereunto set my hand this 29th day of August 2013 in Makati City, Metro Manila, Philippines.         

MARIA B. DELA CRUZAffiant

Voter's ID No. 5555

    SUBCRIBED AND SWORN TO before me this 29th day of August 2013 in Makati City,Metro Manila, Philippines, affiant exhibiting to me her valid proof of identification.Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

For parents who have children prior to their marriage, their children can be legitimated by executing an affidavit of legitimation and submitting it as well as other requirements to the Office of the Civil Registrar where the child's birth was registered. This is only applicable to parents who have no legal

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impediments to marry at the time of the child's birth, i.e. both are single and both are of legal age.

JOINT AFFIDAVIT OF LEGITIMATION

       WE, ______________ and ______________, both of legal age, Filipinos, husband and wife, respectively, and presently residing at _______________________ after having been duly sworn to in accordance with law, depose and state:

1. That we are the biological parents of _______________ who was born on ____________ in _____________ as evidenced by the attached copy of the child’s Birth Certificate, made an integral part hereof as Annex “A”;

2.  That at the time of his/her birth, we, the biological parents were not yet married, hence his/her status in the original birth certificate was entered as Illegitimate.

3. That at the time of the conception of our child, there was no legal impediment for us to contract marriage;

4. That we contracted marriage on _____________ in ______________ which marriage was solemnized by _________________________, as evidenced by the attached Marriage Contract, made an integral part hereof as Annex “B”;

5. That by virtue of our subsequent marriage, the said child is now legitimated by operation of law, particularly Article 177 of the Family Code of the Philippines; 

6. Hence, we are executing this Affidavit to attest to the foregoing facts, for purposes ofcomplying with the requirements in applying for the legitimation by subsequent marriage of our son/daughter, _____________________ and for the proper recording of such legitimation in his/her civil registry documents and Philippinepassport, to enable him/her to bear the surname of his/her father and be entitled to all the rights of a legitimated child, and for all legal intents and purposes.

IN WITNESS WHEREOF, we have hereunto set our hands this ___________________ in _______________, Philippines.

  

__________________Affiant (father)

____________________Affiant (mother)

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Philippine Passport  No. _____Issued at: ________________Issued on: ________________

Philippine Passport  No. _____Issued at: ________________Issued on: _______________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiants exhibiting to me their valid proofs of identification.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

REPUBLIC OF THE PHILIPPINES)CITY OF MAKATI                      ) S.S.x-------------------------------------x  

AFFIDAVIT OF LOSS 

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         I, GERARDO L. TAN, of legal age, Filipino, single and a resident of 2222 Washington Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law, depose and state:

1. That I am a holder of Automated Teller Machine (ATM) Card No. 123456789 duly issued in my favor by Banco de Oro Unibank, Inc. on January 12, 2010 in Makati City;

2. That I used to put said ATM card in my wallet;

3. That sometime on July 20, 2013, when I arrived home from work, I discovered that said ATM card was no longer in my wallet;

4. That diligent effort to locate the same proved futile;

5. That in view thereof, I now desire and hereby request BDO to issue another ATM card in lieu of the lost one;

6. That I bind myself to save BDO harmless from any loss or damage that it may incur in connection with the issuance of a new ATM card in lieu of the lost one;

7. That I am executing this affidavit to attest to the foregoing facts and for any legal purpose it may serve.

         IN WITNESS WHEREOF, I have hereunto set my hand this 29th day of July 2013 in Makati City, Metro Manila, Philippines.          

GERARDO L. TANAffiant

Voter's ID No. 5555

    SUBCRIBED AND SWORN TO before me this 29th day of July 2013 in Makati City,Metro Manila, Philippines, affiant exhibiting to me his valid proof of identification.

Doc. No. _____;Page No. _____;Book No. _____;

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Series of 2013. 

REPUBLIC OF THE PHILIPPINES)CITY OF MAKATI            ) S.S.x----------------------------x  

AFFIDAVIT OF LOSS

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 I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I am a duly-licensed driver in accordance with pertinent Land Transportation laws, rules and regulations, and was issued a corresponding (Non) ProfessionalDriver's License with number _____________ which is valid until _____________;

2. Sometime on ____________, said driver's license was misplaced and got lost;

3. Efforts were exerted to locate said driver's license, but in spite of diligent search, it could not be found and the same is now beyond recovery;

4. Said Driver's License has not been confiscated by the LTO, Police or other Traffic Enforcers for any traffic violation;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and to support my application for the issuance of a new (Non) Professional Driver's License, in lieu of the one that was lost;

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Makati City, Metro Manila, Philippines.

____________________Affiant

SSS ID No. _____________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence ofidentity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

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REPUBLIC OF THE PHILIPPINES)CITY OF MAKATI            ) S.S.x----------------------------x  

AFFIDAVIT OF LOSS OR/CR 

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 I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I am the registered owner of a motor vehicle which is particularly described as follows:                 Make & Type :  ______________             Motor Number : ______________             Chassis Number : ____________             Plate Number : ______________             MV File No. : ________________             Year Model/Color : ___________

2. As proof of ownership of the above-described vehicle I was issued by the Land Transportation Office, Official Receipt (OR) and Certificate of Registration (CR);

3. The said documents while in my possession were misplaced and could no longer be located in spite of diligent efforts to locate them;

4. Said documents were neither transferred to other persons/entity/financial institutions for any consideration nor encumbered to guarantee financial obligations with any financial institution;

5. Said documents were not confiscated by any government authorities for violation of R.A. 4136 and other related laws;

6. I shall assume responsibility or liability if in any event I will use these documents for whatever illicit transactions;

7. I am executing this affidavit to attest to the veracity of my statements and to support my request for duplicate copies of the lost MVRR/MVMRR/OR/CR with the Land Transportation Office (LTO).

IN WITNESS WHEREOF, I have hereunto set my handthis ___________________ in Makati City, Metro Manila, Philippines.

____________________Affiant

SSS ID No. _____________

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 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence of identity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

REPUBLIC OF THE PHILIPPINES)CITY OF MAKATI            ) S.S.x----------------------------x  

AFFIDAVIT OF LOSS

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 I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. I maintain a Savings Account with S/A No. _____________ with _____________ Bank with a credit balance of _____________ (P_____________);

2. Sometime on ____________, the passbook of the above-mentioned account was lost in the following manner:

    ___________________________________________________    ___________________________________________________

3. Despite diligent efforts exerted, I could no longer locate, find or recover the said passbook, and to the best of my knowledge, the same is truly lost;

4. In view thereof, I now desire and hereby request ______ Bank to issue another passbook in lieu of the lost one and I am willing to surrender the lost passbook in the event that the same could be found;

5. As such, I am executing this affidavit to attest to the foregoing facts and to support the application for the issuance of a new passbook in lieu of the one which was lost. 

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Makati City, Metro Manila, Philippines.

____________________Affiant

SSS ID No. _____________

        SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his/her competent evidence ofidentity by way of __________________ issued at ______________ on __________________.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

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REPUBLIC OF THE PHILIPPINES)CITY/MUNICIPALITY OF _____ ) S.S.x-------------------------------------x  

AFFIDAVIT OF LOSS

   I, ___________________, of legal age, Filipino, single and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

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1. Sometime on ______________, I pawned my _________ with TambuntingPawnshop located at _____________________ and for which I was issued Pawn Ticket/Receipt No. _________;

2. I kept the said pawn ticket in my wallet for safekeeping but unfortunately my wallet got lost;

3. Despite diligent search and efforts to locate the said wallet and pawn ticket, I could not find the same such that I believe that they are now lost beyond recovery; 

4. As such, I am executing this affidavit to attest to the foregoing facts and to enable me to secure a duplicate or substitute copy of the ticket and/or redeem the above-described item which I pawned.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in ____________, Philippines.

____________________Affiant

GSIS ID No. _____________

  SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant exhibiting to me his valid proof of identification.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

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REPUBLIC OF THE PHILIPPINES)CITY/MUN. OF ____________ ) S.S.x-------------------------------------x  

AFFIDAVIT OF PARENTAL CONSENT TO MARRIAGE

I/WE, ________________________ of legal age, Filipino citizen/s, single/married/widow and presently residing at _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

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1. I am/we are the mother/father/parents of ______________________ born in ______________________ on ________________;

2. My/Our child is intending to contract marriage with ____________________ in ______________________;

3. I am/we are giving my/our consent to my/our child, ___________________, marrying said ________________;

4. I am/we are executing this Affidavit for the purpose of informing the authorities concerned of the veracity of the foregoing facts and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, I/we hereby affixed my/our signature/s this day of ___________________ in _______________, Philippines.

  

__________________Affiant

SSS ID No. _____________

____________________Affiant

SSS ID No. _____________

SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiant/s exhibiting to me his/her/their valid proof/s of identification.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.

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The affidavit of single status is also known as the Certificate of Freedom to Marry, Certificate de Coutume, Certificate of No Impediment, Certificate of Nulla Osta, Single Status Statutory Declaration, Certificate of Legal Capacity to Contract Marriage, Single Status Certificate, Affidavit of Free Status. This document is required by almost all countries before a marriage license is issued to foreigners intending to contract marriage. Sample form:

EMBASSY OF THE REPUBLIC OF THE PHILIPPINES)RIYADH, SAUDI ARABIA                                   ) S.S.x--------------------------------------------------------x  

AFFIDAVIT OF SINGLE STATUS

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        I, MARIA C. DELA CRUZ, of legal age, Filipino, with Philippine address at 123 Mangga Street, General Santos City, after having been duly sworn to in accordance with law, do hereby depose and say:

1. THAT I have never contracted any marriage in the Philippines or elsewhere and I remain SINGLE to this very day and hour;

2. THAT there is no legal impediment for me to contract marriage under the PhilippineLaws;

3. THAT I am executing this Affidavit for the purpose of complying with the requirements relating to my forthcoming marriage to PEDRO B. RUIZ in Riyadh;

4. THAT I declare that the statements made in this affidavit are true and correct and I am willing to bear all the legal responsibilities arising therefrom. 

IN WITNESS WHEREOF, I have hereunto set my hand this 1st day of August 2013 at the Philippine Embassy, Riyadh, Saudi Arabia.

MARIA C. DELA CRUZAffiant

         SUBCRIBED AND SWORN TO before me this 1st day of August 2013 at thePhilippine Embassy, Riyadh, Saudi Arabia, affiant exhibiting her Philippine Passport No. 123456789 issued on June 7, 2010 in Manila, Philippines.

Doc. No. _____Service No. _____Series of: ______Fee Paid: ______O.R. No.: ______

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A travel clearance is required and shall be secured from the DSWD by the following Filipinocitizens: 

1.    A minor traveling alone to a foreign country; 

2.   A minor traveling to a foreign country accompanied by a person other than his/her parents.

3.   A minor who is the subject of ongoing custody battle between parents will not be issued a travel clearance unless a Court Order is issued to allow the child to travel abroad with either one of his/her parents or authorized guardian.

The travel clearance protects minors who travel alone from human traffickers who take advantage on children’s vulnerabilities. To secure a travel clearance, an Affidavit of Supportand Consent to Travel is often required. 

AFFIDAVIT OF SUPPORT AND CONSENT TO TRAVEL

Page 31: List of Affidavits

  I/WE, _______________________, of legal age, Filipino(s), single/married/widow/widower and presently residing at _______________________ after having been duly sworn to in accordance with law, depose and state:

1. That I/we am/are the biological father/mother/parents of _______________ who was born on ____________ in _____________.

2.  That said child/children will travel to __________________ (country) for the following reason/s: ______________________________________;

3. That said child/children will be leaving on _____________________ and will stay in the said country for a period of _________________________ and will be taken cared of by ______________________;

4. That I/we cannot personally travel with my child/children due to the following reasons: _________________________________;

5. That I am/we are giving my/our full consent for the minor child/children to travel abroad to be accompanied by _________________________;

6. That I/we personally guarantee the financial support of the child/children in the course of his/her/their travel and stay outside the Philippines and further guarantee that he/she/they will not in any manner become a burden to the Philippine and ___________ governments.

7. That I/we am/are executing this affidavit in connection with my/our child/children application for a passport at the Department of Foreign Affairs and/or travel clearance from the Department of Social Welfare and Development for his/her/their travel abroad.

IN WITNESS WHEREOF, we have hereunto set our hands this ___________________ in _______________, Philippines.

  

__________________Affiant

Philippine Passport  No. _____Issued at: ________________

____________________Affiant

Philippine Passport  No. _____Issued at: ________________

Page 32: List of Affidavits

Issued on: ________________  Issued on: _______________

 SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiants exhibiting to me their valid proofs of identification.

Doc. No. _____;Page No. _____;Book No. _____;Series of 2013.