REPUBLIC OF THE PHILIPPINES )

City of ______________________ )S.S.

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

AFFIDAVIT OF CHANGE OF ADDRESS
I, ______________________, FILIPINO, of legal age, married to
______________________, and a resident of
______________________, Philippines, after being duly sworn in
accordance with law, depose and state:
1. That I am a holder of an ACR-ICARD No.
______________________ issued on ______________________
valid until ______________________.
2. That I am married to a Filipino and we are continuously and
harmoniously living with each other as husband and wife up to the
present.
3. That we have moved our place of residency from
______________________ to ______________________
4. As such, I am executing this Affidavit of Change of Address to attest
to the truth of the foregoing and for whatever purpose this may
serve.
IN WITNESS WHEREOF,I have hereunto set my hand this ___ day of
______________________ in the City of ______________________,
Philippines.

______________________
Affiant

SUBSCRIBED AND SWORN to before me, this ___ day of

______________________ in the City of ______________________,
affiant exhibiting before me his proof of identity:
______________________.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2017.