Republic of the Philippines )

La Trinidad, Benguet ) s.s.

AFFIDAVIT
Re: Philippine Passport

I, _____________________, of legal age, married, Filipino citizen and with residence and
postal address at ______________________________t, Philippines, under oath hereby depose and
state that:

1. I am processing the authentication of my documents with the Office of Consular

Affairs, Department of Foreign Affairs, Manila, Philippines relative to my
migration in Spain;

2. I was issued a Philippine passport by the Department of Foreign Affairs, Baguio

City on December, 2016;

3. A true copy of my passport is hereto attached to form part hereof;

4. I am executing this affidavit to attest to the truthfulness of the foregoing

statements and for all legal intents and purposes it may serve.

IN WITNESS HEREOF, I have hereunto set my hand this _____________________, Benguet,

Philippines.

X
Affiant

Subscribed and sworn to before me this ___________________________________________, at La

Trinidad, Benguet, Philippines, affiant personally appeared before me and acknowledged the
foregoing as his voluntary act and deed.

Doc. No. ____;

Page No. ____;
Book No. ___;
Series of ____.