REPUBLIC OF THE PHILIPPINES)

CITY OF DUMAGUETE .............…) S.S

AFFIDAVIT OF EXPLANATION

I, NOEL DE GRACIA NUIQUE of legal age, Filipino, single, resident of Nagbagang,

Sta. Catalina, Negros Oriental, Philippines after having been sworn in accordance with law,
depose and say that:

1. I am holder of passport EB9514096 issued on November 5, 2013 by DFA Cebu valid

until November 4, 2018, I am currently renewing my passport in Dumaguete City;

2. I am in the process of facilitating the renewal of my passport in Dumaguete City;

3. I am requesting the Department of Foreign Affairs RCO Dumaguete for the early
renewal of my passport due to the fact that I am to be deployed overseas and will not be able to
renew my passport overseas due to the nature of my work therein;

4. Thus , I am opting to renew my passport early to ready my passport for immediate

travel abroad and comply with company requirements ;

5. I am executing this affidavit to attest to the truth of the foregoing statement and for all
legal purposes it may serve;

6. I hereby assume full criminal, civil and administrative liability in case of any action,
charges, suit, proceeding, prosecution or investigation that may be filed against me or any person
by any court of justice, tribunal, board, agency, quasi-judicial body or office should any of the
document or paper I submitted be found dubious, spurious or fake, or should any of my
statements and declarations be found to be false or unfounded;

7. I shall waive any and all rights, actions, charges, suits, claims and cases against the
Department of Foreign Affairs or the government or any of its officer or employee in case of
denial or approval of this application, or in case of damage, injury or death arising from any
travel that I may undertake during, after, pursuant to or consequent to this application, or in case
of any action, suit, proceeding, prosecution or investigation that I may be subjected to by virtue
of this application;

8. This affidavit is executed to attest to the truthfulness and veracity of my statements

above.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th day of

February 2017 at Dumaguete City, Philippines.

NOEL DE GRACIA NUIQUE

Affiant

SUBSCRIBED AND SWORN to before me this 14th day of February 2017, at

Dumaguete City, showing to me as proof of identity his Philippine passport EB9514096.

Doc. No.: ____

Page No.: ____
Book No.: ____
Series of 2017.