TokyoPE_ASC Form

October 2021

AFFIDAVIT OF SUPPORT AND CONSENT

I, ____________________________________________________, Filipino, of legal age,

and presently residing at ____________________________________________________
(address in Japan)
_______________________________________ after having been duly sworn to in
accordance with law, hereby depose and state that:

(1) I am the mother / father / court-appointed legal guardian of the following child(ren):

 _______________________________ born on ____________ in_______________

 _______________________________ born on ____________ in _______________
 _______________________________ born on ____________ in _______________
 _______________________________ born on ____________ in _______________

(2) I am giving my consent for the said child(ren) to travel abroad accompanied by
______________________________________________________________;

(3) I am paying for the expenses of their travel;

(4) I am financially capable to provide for their accommodation, sustenance and support
during their sojourn;

(5) I guarantee that they will not violate any law of their destination country;

(6) I am executing this affidavit in connection with my child(ren)’s/ward’s application for a

passport at the Department of Foreign Affairs and/or travel clearance at the Department of
Social Welfare and Development for travel abroad.

IN WITNESS WHEREOF, I have hereunto signed my name this __________day of

______________________ in Tokyo, Japan.

Affiant
Full name and Signature

The Consular Section of the Philippine Embassy in Tokyo, Japan assumes no responsibility for the contents of this document as written
by the applicant.