REPUBLIC OF THE PHILIPPINES)

Province of____________________) S.S.

City/Municipality of_____________)
x---------------------------------------x
AFFIDAVIT OF SUPPORT
FOR SELF SUPPORTING FOREIGNER STUDENT
I, ________________(name of affiant)____________, _______
citizen, of legal age, [single]/[married to _________(name of
spouse)_________],
and
a
resident
of
___________________(address of affiant)_______________, after
having been duly sworn in accordance with law, hereby depose and
state:
1. That I traveled and came to the Philippines on a tourist visa;
2. That for the said purpose, I have sufficient financial
capabilities with savings and assets to defray all my expenses
during and for the duration of my stay in the Philippines;
3. That I warrant, undertake and guarantee to assume any and
all expenses which I may incur while staying in the Philippines;
4. That there is no criminal case pending in court against me,
nor have I been charged of subversion, rebellion, or
insurrection, smuggling or drug use in any court in the
Philippines;
5. That I will not be a liability or a public charge in this country;
6. That I am executing this to attest to the veracity of the
foregoing statement and for stating categorically and under
oath the truth and facts of the above information;
7. That finally, I am executing this for whatever legal intents and
purposes it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
____th day of ____________ 20___ at ____________, Philippines.

_______________(signature)__________________
(Printed Name)

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for

_________(City/Province)____________ this ____th day of ____________
20___. Affiant personally came and appeared with _____________(Competent
Evidence of Identity)______ issued by the _________(Government
Agency)______ on ___(date)__ at ________(place)_________, bearing his
photograph and signature, known to me as the same person who personally
signed the foregoing instrument before me and avowed under penalty of law to
the whole truth of the contents of said instrument.

Doc. No. ____

Page No. ____
Book No. ____
Series of 20__

[13upCD]

Atty ______________________________________
Notary Public
Commission Serial No. __________________
Notary Public for _______(Province/City)_____
Until December 31, 20__
Office: ______________(address)__________
Roll No. __________
IBP Lifetime Roll No. ________; __/__/__ ; (Province)
PTR No. _________ ; __/__/__ ; _(Province)_
MCLE Compliance Cert. No. __________; __/__/__