REPUBLIC OF THE PHILIPPINES

TARLAC CITY, PHILIPPINES

) S.S.

AFFIDAVIT OF SUPPORT
I, _________________________________, of legal age, ___________ citizen,
presently residing at ____________________________________________________,
Peoples Republic of China, after having been duly sworn to in accordance by law,
hereby depose and say that:

1. I am the father/mother of ___________________________________________,

born in __________________________ on ____________________________
with Passport No. _______________ issued in ___________ on______________;

2. I have given my child the full support and consent and permission to travel to the
Philippines to __________________________________ to be accompanied by
______________________________;

3. I have the financial means and support to finance the necessary funds to cover for
any and all travel requirements prescribed by the Government of the Philippines
and by virtue thereof the possibility of his/her becoming a public burden to the
4. I am executing this affidavit to request the appropriate Philippine authorities to
issue my child a Waiver of Exclusion Ground and to attest to the truth of the
foregoing facts and circumstances.

IN WITNESS WHEREOF, I have hereunto set my hand on this _________ day of

___________ 20 ____, in Beijing, China.

_______________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of _____________ 20_____,

in Beijing, China, affiant exhibiting to me his/her Philippine Passport No.
______________ issued on ____________ at ________________, ______________ .

Document No.: _________

Service No.: _________
Series of 20 _________ _____________________
Fee Paid: _________ Consul
O.R. No.: _______