REPUBLIC OF THE PHILIPPINES )

Province of __________________ )
Municipality/City of ____________ ) S.S.
x - - - - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF CONSENT AND SUPPORT

I, __________________________, of legal age, single / married to ________________, Filipino, and a

resident of ____________________________________________________, Philippines, with mobile number
_______________________ and with Identification No. __________________ issued by ______________, after
having been duly sworn in accordance with law, hereby deposes and states:

1. That I am the biological father/mother of ___________________________, minor,

___________________ of age, he/she having been born in ___________________on __________________,
citizen of the Republic of the Philippines;
2. That I am giving full consent and authority to minor _____________________________ to travel with
my husband/wife, _______________________, holder of Philippine Passport No. _____________________ and
to secure his/her own passport from the Department of Foreign Affairs, ____________ City;
3. That I am giving full consent and authority to my husband to submit all required documents and pay
the necessary fees to the Department of Foreign Affairs, ______________ City for the processing of his/her
passport and that he/she is also authorized to claim and receive the passports in my behalf and our child;
4. That I am willing and able to maintain and support my child financially and guarantee that he/she will
not become a public charge or burden during their travel and that I have sufficient and adequate financial capacity
to support and defray the said travel and do hereby undertake to finance his/her transportation expense;
5. That there is no criminal case pending in court against us nor have we been charged of subversion,
rebellion, insurrection or any crime or offense involving moral turpitude in any court of the Philippines;
6. That I am executing this affidavit to declare the truth of the foregoing facts and for whatever legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _______ day of _____________
20____ at __________________________ City, Philippines.

__________________________________
Affiant
CTC/Valid ID No. _____________________
Issued by __________________________

JURAT
SUBSCRIBED AND SWORN TO BEFORE ME, Affiant having exhibited his/her competent proof of
identity as written under his/her name.
________________________ City, Philippines, ________, 20____.

Doc. No._____;
Page No._____;
Book No._____;
Series of 20___.