Republic of the Philippines )

CITY OF SAN PEDRO S.S

Province of Laguna
x-------------------------------------------x

AFFIDAVIT

I, MARICEL D. TONGOL, of legal age, Filipino and residing at Blk. 27 Lot 6-A
Phase 1 Sta. Lucia Restlement Magalang Pampanga, after having duly sworn to
according to law hereby depose and say:

1. That, I am the same MARICEL D. TONGOL whose name appears on the

Philippine Passport with No. EC4472466 issued on June 23, 2015 valid until June
20, 2020;

2. That, said Passport were legally obtained and secured by the herein affiant;

3. That, these certificate/pertinent documents are in need to be authenticated by

lawful authorities as valid requirements for traveling abroad;

4. That, the said passport that need to be authenticated is described as follow;

Document Validity

a. Philippine Passport with No. EC4472466 June 23, 2015- June 20, 2020

5. That, the copies (original & photo copies) of the above mentioned certificates are
hereto attached to form part of this affidavit;

6. That, I am executing this affidavit in compliance with the requirements needed for
authentication of the document, to attest to the truth of the foregoing statements and for all other
legal intents and purposes this may serve best.

IN TRUTH WHEREOF, I have hereunto set my hand this 17 th day of November,

2017 at the City of San Pedro Laguna.

MARICEL D. TONGOL
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of November, 2017 in San Pedro
Laguna. Affiant having exhibited to me her proof of Identity SSS I.D. with No. 33-2901601-5.

Doc. No: ________

Page No.:________
Book No.:________
Series of 2017