PARENTAL TRAVEL PERMIT

I/We,____________________________________ / ____________________________________ of legal age(s),

(name of applicant/s)
single/married/widower/separated and resident of ________________________________________________________,
(address in the UK)
hereby declare under oath, that:

1) I/We am/are immigrant/s/citizen/s contract worker/s of/in the United Kingdom;

2) That I/We am/are the biological mother/father/parents and/or person/s exercising parental authority over minor/s
________________________________________ / ________________________________________ born on
(name(s) and age(s) of child/children)
____________________________________ / ___________________________________ respectively;
(date/s and place/s of birth)
3) That my/our child/children will travel to _____________________________________________________________;
(destination. e.g. UK)
4) That said child/children will leave the Philippines on ____________________ and will stay at the above address for
(date of departure)
a period of ___________________________ and will be taken care of by me/us.
(state period of stay e.g. 1 mo. 1 yr. Or indefinite)

(For parent/s who will travel with his/her/their child/children to London, please tick YES below and put NA on item
6. If not, please tick NO and state reason on item 6)
5) That I/we will personally accompany my/our child/children during his/her/their travel to London. YES _____ NO _____;

6) That I/we cannot personally travel with my/our child/children due to ________________________________________;
(state reason/s or circumstances)

7) That I/we am/are giving my/our full consent to the travel of the aforementioned child/children abroad to be
accompanied by ______________________________________________ / _________________________________;
(name of person accompanying and relationship to the child/children)

8) That I/we further warrant that he/she/they shall not be a public burden in any way as I/we have sufficient funds to
defray all his/her/their expenses of such travel;

9) That this affidavit was executed for the purpose of attesting to the truth of the facts above stated and for whatever
legal purpose it may serve:

Affiant further sayeth naught.

IN WITNESS WHEREOF, I/We have hereunto signed this Affidavit this _____ day of __________________
20___ at London, United Kingdom.

___________________________ ____________________________
(father’s signature) (mother’s signature)
Philippine/UK Passport No. __________ Philippine/UK Passport No. __________
Date of Issue _______________ Date of Issue _______________
Place of Issue _______________ Place of Issue _______________

EMBASSY OF THE PHILIPPINES)

CONSULAR SECTION ) SS
LONDON, UNITED KINGDOM )

SUBSCRIBED AND SWORN to before me this ______ day of ______________________ 20___, in the City of
London, United Kingdom, affiant/s exhibiting his/her/their Passport/s.

Doc. No. :____________

Serv No. :____________

O.R. No. :____________

Fee paid : £ 23.00

ptp form revised 01/17 – Philippine Embassy, London This form is not for sale and can be reproduced