Republic of the Philippines)

Province of Negros Oriental)

City of Dumaguete. . . . . . . )

AFFIDAVIT OF EXPLANATION
(For a Damaged Passport)

I, ROMEL DEJADA MOLINA, of legal age, Filipino, married, and

presently residing at Purok Cross-Tac, Barangay Taclobo, Dumaguete City,
Negros Oriental, after having been duly sworn to in accordance with law, hereby
depose and state that:

1. I am the same affiant who personally and voluntarily caused the

preparation and execution of this Affidavit;

2. I was issued on March 13, 2013, by the Department of Foreign Affairs

(DFA) Cebu, a Philippine passport with serial number EB7630997;

3. The said passport was damaged in the year of 2017 because of the
following circumstances;

 I stored the said passport inside my luggage for so long;

 Because of its non-use, it generated a moisture like particles that
eventually damaged my passport.

4. The damage to my passport issued in my name was inadvertent and

unintentional;

5. I am executing this Affidavit to declare the factual circumstances as to

how said passport was damaged beyond further use and to support my
present application for a new passport to replace the one that was
damaged; and

6. Each and all of the facts stated above are true and correct, and made with
full awareness that I may be held liable for perjury and have the passport
issued in my name cancelled if any misrepresentations or falsehoods are
found to have been made in this Affidavit.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7th

day of November, 2022, in Dumaguete City, Philippines.

ROMEL DEJADA MOLINA

Affiant
NON-PROFESSIONAL DRIVER’S LICENSE ID NO.: F03-06-006642
SUBSCRIBED AND SWORN to before me this ____________________
at Dumaguete City, Philippines, affiant exhibiting to me his respective identity
card as shown above, bearing his picture and signature as his competent proof of
identity and declaring further before me under oath that he is the same person who
appeared and signed the foregoing instrument in my presence and within my
jurisdiction, and he avowed to the truth of its contents under penalty of law.

Doc. No.  ______;

Page No. ______;
Book No.  ______;
Series of 2022.