REPUBLIC OF THE PHILIPPINES)

__CITY )S.S.

AFFIDAVIT OF SUPPORT

We, spouses _____ and______, both of legal age, Filipino citizens and
residing at _____________, after having been duly sworn to according to law, hereby
depose and state:

1. That we are the legitimate parents of _______________, who is ________

years old;

2. That our above-named ___ is schedule to leave for __________ on _____ ;

3. That since our said son is travelling alone and is still a minor, we hereby
give our consent freely and voluntarily for him/her to travel to ___________
on said date;

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

___________ , at the City of __________-.

Father’s Signature Mother’s Signature

SUBSCRIBED AND SWORN to before me, this ________ by _____ who exhibited
to me his/her ID No. Issued at __________, Philippines on ______.

Doc No.:__
Page No.:__
Book No.:___
Series of 202__