Republic of the Philippines )

) S.S.

AFFIDAVIT

I, CARLITO DANGCIL CORTEZ, Filipino, of legal age, single, and a

resident of 122 Sacred Heart Street, Barangay San Antonio, Makati City,
Metro Manila, Philippines, after being sworn to in accordance with law,
hereby depose and state that:

1. I was born on 29 April 1988 in Quezon City as Carlito Dangcil Cortez;

2. I applied and was granted a Philippine passport by the Department of

Foreign Affairs Manila for the first time on 3 April 2019 with passport
number P1329789B;

3. I have not previously traveled outside the Philippines;

4. I intend to take a personal trip to the People’s Republic of China this

2019 with a group friends;

5. I am executing this Affidavit to attest to the truth of the foregoing and

for purposes of my application for Chinese visa with the Embassy of
the People’s Republic of China in Manila.

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of

May 2019 in _____________________, Metro Manila, Philippines.

CARLITO D. CORTES
Affiant

SUBSCRIBED AND SWORN to before me this _____________________ in

__________________, affiant exhibiting to me her ____________________ with ID
number ______________________ issued in ______________ on ________________.

Notary Public

Doc No. _________;

Page No. ________;
Book No. _______;
Series of 20_____.