REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO ) S.S.

x-------------------------------------x

AFFIDAVIT OF APPEARANCE

I, _______________________________, of legal age,

married/single and a __________ citizen, after having
been sworn in accordance with law, do hereby depose
and state that:

1. I am presently residing at
________________________________________________ and have
been in the United States since
________________________________.

2. In compliance with the requirement of the:

__________________________________________________________
_________
(Name of Office or Agency in the Philippines)

3. I have executed this AFFIDAVIT to attest the fact

that I indeed live at the above address, and

4. I have attached herewith a photocopy of each of

my identification document/s for further reference.

IN WITNESS WHEREOF, I have hereunto affixed my

signature on this _________ day of ______________, 20 ______
in _______________________.

______________________
Affiant

Witnesses:

_____________________ ______________________