DSWD-PMB-GF-003 | REV 01 / 29 OCT 2021

November 22, 2023

Date: _______________

CONSENT TO TRAVEL

Nico S. Vergara
I/We ___________________________________ Marian Fae M. Vergara
and ______________________________,
of legal age, _______________
married (civil status), ________________(nationality),
Filipino and a resident
of _______________________________________________________,
131 San Francisco Macabebe, Pampanga, Philippines and with tel.
no.___________________.
63 949 160 8646

___________
I am/We are the father/mother/legal Nehemiah M. Vergara
guardian of ________________________________,
________________________________, and _________________________________.
My/Our child/children will travel to _______________________,
Abu Dhabi ____________________,
United Arab Emirates
__________________________, ________________, (country) for the following reason/s
_________________________________________________.
to join us for vacation in the said country She/ He/ They will be leaving
on _____________________________
December 15, 2023 and stay in the said country for a period of
_____________________
32 days and will be taken care of_______________________________.
us, her parents.

I am/we cannot personally travel with my child/children due to the following

reason/s_________________________________________________________.
we are both Overseas Filipino Worker here in Abu Dhabi, UAE I am/we
are giving my/our full consent for the minor child/children to travel abroad accompanied by
____________________________________________,
Dinah Remedios M. Laguing _______________________.
my sister I/We
personally guarantee that he/she/they will not in any manner become public ward/s of any
authority of any country he/she/they may happen to pass en route to his/her destination.

Nico S. Vergara Marian Fae M. Vergara

FATHER MOTHER

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DSWD Field Office III, Government Center, Maimpis, City of San Fernando, Pampanga, 2000 Philippines
Website: www.fo3.dswd.gov.ph Tel Nos.: (045) 961-2143