AFFIDAVIT OF SUPPORT AND CONSENT TO TRAVEL

AND SPECIAL POWER OF ATTORNEY

I / We,
____________________________________________________________,
single/married to ____________________________________________, and residing
at
_____________________________________________________________________
___
hereby declare that:

1) I / We am/are permanent resident(s)/citizen(s)/ of the United States, or on

__________________ visa status;
2) My/Our minor child/children
_______________________________________
__________________________________________________________
___
is/are applying for Philippine passport(s) in the Department of Foreign
Affairs, in order to join me/us here in the United States;
3) I/We am/are willing and able to support him/her/them during their visit;
4) I/We authorize ________________________________ to file said
passport
application(s) on behalf of my child/children;
5) I/We designate _______________________________ to accompany
said child/children during the travel from the Philippines to the United
States;
6) I/We also authorize ________________________________________,
who
reside at
_____________________________________________________
to secure a clearance from the Department of Social Welfare and
Development for the travel of minor child/children, who is scheduled to
depart
for the U.S. on __________________________;
7) Said child/children will stay with me/us at
____________________________
__________________________________________________________
__
upon arrival.

DONE this ______ day of ____________, 200__, in

________________________.
___________________________
___________________________
Father Mother