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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF COTABATO ) S.S.


MUNICIPALITY OF MIDSAYAP )
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AFFIDAVIT OF CONSENT TO TRAVEL ABROAD

That I, SUSAN A. LOPEZ, of legal age, Filipino, married and resident of


Villarica, Midsayap, Cotabato, after having been duly sworn in accordance with
law, do hereby depose and say:

That I am the mother of Robert Spencer A. Lopez and Hanyr Rick A.


Lopez who were born on October 2, 1995, and May 5, 2004, respectively, at
Midsayap, Cotabato;

That both Robert Spencer A. Lopez and Hanyr Rick A. Lopez are only 17
years old and 12 years old respectively;

That both Robert Spencer A. Lopez and Hanyr Rick A. Lopez are under my
care and custody because their father is working abroad;

That my sister in-law Cherry I. Lopez who is the aunt of Robert Spencer
A. Lopez and Hanyr Rick A. Lopez will go to Singapore for a vacation and at the
same time to visit her sister Judith I. Lopez;

That I giving my consent that my children Robert Spencer A. Lopez and


Hanyr Rick A. Lopez will travel abroad accompanied by their aunt Cherry I. Lopez
to visit their other aunt Judith I. Lopez in the state of Singapore.

That I am giving my consent without being forced, threatened or


intimidated to allow my son to travel abroad accompanied by Cherry I. Lopez in
the state of Singapore;

That I execute this affidavit to attest to the truth of the foregoing facts
and for whatever legal purpose the same may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day


of March 2013, at Midsayap, Cotabato, Philippines.

SUSAN A. LOPEZ
Affiant
Voter's ID No. 4709-0270B-
G-2169SAL2000

SUBSCRIBED AND SWORN to before me this _____ day of March


2013, at Midsayap, Cotabato, Philippines.

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