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I, Benjamin A. Santiaguel Jr., of legal age, Filipino, married and presently residing
at _______________________ after having been duly sworn to in accordance with law,
depose and state:

1. That I am the husband of Alice R. Santiaguel who was born on ____________ in
2. That said wife will travel to Australia for the following reason/s:
3. That said wife 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 cannot personally travel with my child/children due to the following
reasons: _________________________________;
5. That I personally guarantee the financial support of my wife in the course of her
travel and stay outside the Philippines and further guarantee that she will not in any
manner become a burden to the Philippine and ___________ governments.
7. That I am executing this affidavit in connection with my wife’s application for a
VISA at the Department of Foreign Affairs and/or travel clearance.

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

Philippine Passport No. _____
Issued at: ________________
Issued on: ________________

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

affiants exhibiting to me their valid proofs of identification. . Series of 2013. Philippines. No. _____. Book No. _____. _____. Page No. Doc.SUBCRIBED AND SWORN TO before me this ___________________ in _________________.