(Affidavit of Parental Consent for Child to Apply for Student Driver's Permit)

REPUBLIC OF THE PHILIPPINES)

Province of ____________________) S.S.

City/Municipality of _____________)

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

AFFIDAVIT OF CONSENT

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

having been duly sworn in accordance with law, hereby depose and state:

1. That I am the father of _____________, who is applying for a Student Driver's Permit at the
Land Transportation Office (LTO);

2. That I am giving my full consent to my said (son/daughter) in (his/her) application for a

Student Driver's Permit;

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

4. That I am executing this affidavit to declare the truth of the foregoing facts as to my
undertaking to give consent to my (son/daughter)'s application for Student Driver's Permit.

IN WITNESS WHEREOF, we have hereunto set our hands this _____________ at

_____________, Philippines.

AFFIANT

(JURAT)