Republic of the Philippines )

Province of Zamboanga del Norte)S.S.

City of Dipolog )
x--------------------------x

AFFIDAVIT OF CONSENT AND SUPPORT

I, SHEILA ALIPOYO ROMERO, of legal age, divorcee, Filipino, and a

resident of PNB Subdivision Compound, Governor’s Village, Estaka, Dipolog City,
Philippines, with cellphone number +63999-687-9772, respectively, after having been
duly sworn in accordance with law, hereby depose and state:

1. That I am the parent and legal custodian of ALIESAH A. ROMERO and ANDRI
A. ROMERO both minors and citizens of the Republic of the Philippines, holders
of valid Philippine Passport with Nos. _____________ and who are going for a
trip abroad specifically to South Korea this _____________;
2. That I am giving my full consent to my said children to travel abroad
or specifically to _____________;
3. That for this purpose, I have sufficient and adequate financial capacity to support
and defray the said travel and do hereby undertake to finance their trip abroad
from the application fees, airline tickets, board and lodging, pocket money and
such other expenses that they may incur so that they would neither be a burden
to the state nor at their place of destination at any time during their trip abroad;
4. That there is no criminal case pending in court against them nor has been
charged of subversion, rebellion, insurrection or any crime or offense involving
moral turpitude in any court of the Philippines;
5. That further, ALIESAH A. ROMERO and ANDRI A. ROMERO will be
accompanied or escorted by their grandfather _________________ in their
travel abroad;
6. That I hereby giving my full consent to the said ____________ to accompany or
escort ALIESAH A. ROMERO and ANDRI A. ROMERO in their travel abroad;
7. That I am executing this affidavit to declare the truth of the foregoing facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 26 th day

October, 2018 at Dipolog City, Philippines.

SHEILA ALIPOYO ROMERO

Affiant
Driver’s License No.
L04-98-046844
Issued in LTO, Oroquieta City, Misamiz Occidental
Issued on April 2, 2018

SUBSCRIBE AND SWORN to before me this ______________ at Dipolog

City, Philippines, with affiant exhibiting her VALI ID which is stated above.

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 SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, SHEILA ALIPOYO ROMERO, of legal age, Filipino, divorcee and a resident of PNB
Subdivision Compound, Governor’s Village, Brgy. Estaka, Dipolog City, do hereby name, constitute and
appoint, _______________, of legal age, Filipino, married and also a resident of PNB Subdivision
Compound, Governor’s Village, Brgy. Estaka, Dipolog City, to be my true and lawful attorney, for me
and in my name, place and stead, to do and perform the following acts and things to wit:

1. To transact, follow-up, receive, demand, sign and claim any transactions from any government
and private entities

2. TO DO ACT AND EXECUTE other things as may be required and necessary to carry into
effect the foregoing authority.

HEREBY GIVING AND GRANTING unto my said attorney in-fact full power and authority
whatsoever requisite or necessary or proper to be done in and about the premises as fully to all intents and
purposes as I might or could lawfully do if personally present and hereby, ratifying and confirming all
that my said attorney-in-fact shall lawfully do or cause to be done under and by virtue of these presents.

IN WITNESS WHEREOF, I hereunto set my hand this ______ day of _________ at Dipolog
City, Zamboanga del Norte, Philippines.

SHEILA ALIPOYO ROMERO

PRINCIPAL
Driver’s License No.
L04-98-046844
Issued in LTO, Oroquieta City, Misamiz Occidental
Issued on April 2, 2018

SIGNED IN THE PRESENCE OF

____________________ _____________________

Republic of the Philippines )

Province of Zamboanga del Norte )S.S
City of Dipolog )
x----------------------------------------x

ACKNOWLEDGEMENT

BEFORE ME, this ____________ at Dipolog City, Zamboanga del Norte, Philippines, personally
appeared this above-named person with her Identification Card, known to me to be the same person who
executed the foregoing and that she acknowledged to me that the same is her free act and deed.

WITNESS MY HAND AND SEAL.

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