REPUBLIC OF THE PHILIPPINES )

LEGAZPI CITY, ALBAY ) S.S.

AFFIDAVIT
I, ______________, Filipino, of legal age, married to ______________ (Australian National), and
a resident of ______________, after being sworn to in accordance with law, hereby depose and state
that:

1. I am applying for Non-Quota Immigrant Visa by Marriage to a Filipino Citizen under Section
13 (a) of the Commonwealth Act No. 613 in favor of my husband, ______________, an
Australian national;

2. In connection with the said application, I hereby submit the following documents to the
Bureau of Immigration in support thereof:
a. Photocopy of the all pages of the passport of the applicant, including but not limited
to:
i. Bio-page; and
ii. Latest immigration admission
b. Marriage Certificate;
c. My Birth Certificate issued by the National Statistics Office; and
d. NBI Clearance issued for my spouse.

3. In addition, I am also required to submit such other documents for the processing of my
application/request;

4. I hereby GUARANTEE that the above mentioned documents, in addition to all other
documents, which I am submitting for application/request for Non-Quota Immigrant
Visa by Marriage to a Filipino Citizen under Section 13 (a) of the Commonwealth Act No.
613 are GENUINE and that I have NO INTENTION TO DEFRAUD the government or other
party/ies;

5. I am executing this Affidavit to comply with the requirements of Bureau of Immigration in

support of my request/application for Non-Quota Immigrant Visa by Marriage to a
Filipino Citizen under Section 13 (a) of the Commonwealth Act No. 613, to attest to the
truth of the foregoing statements and for whatever legal purpose/s it may serve.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of July 2021 at Legazpi City,
Albay.

______________
Affiant

SUBSCRIBED AND SWORN to before me this 13th day of July at Legazpi City, Albay, affiant
exhibited to me her ______________, as competent evidence of her identity.