REPUBLIC OF THE PHILIPPINES)

City of Cebu…………………..) S.S.

x-----------------------x

AFFIDAVIT OF CONSENT

I, _____________, Filipino, of legal age, married, and a resident of

___________________after being duly sworn in accordance with law, depose
and state:

1 That I am the mother of _______________, who is applying for a

Student Driver’s Permit at the Land Transportation Office;

2 That I am hereby giving my full consent to my said daughter’s

application for Student Driver’s Permit;

3 That there is no criminal case pending in court against her nor she
been charged of subversion, rebellion, or insurrection in any court
of the Philippines;

4 Thus, I execute this affidavit declare the truth of the foregoing

facts as to my undertaking to give consent to my daughter’s
abovementioned application.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________

at Cebu City, Philippines.

___________________________
AFFIANT

SUBSCRIBED AND SWORN to before me, this __________________ by the

Affiant who is exhibited her _______________________________ as competent
proof of identity.

Doc. No. ______;

Page No. _____;
Book No.______;
Series of 2019.