Republic of the Philippines)

Province of Tarlac ) s.s.

AFFIDAVIT OF CONSENT
with SPECIAL POWER OF ATTORNEY

That I, MARILOU M. SOTTO, of legal age, Filipino and a resident of Brgy.

Poblacion 2, Gerona, Tarlac after being duly sworn to in accordance with law do
hereby deposes and states:

1. That I am the mother of the minor children namely: JULIE ANN S.

SIMEON born on July 8, 1999 at Gerona, Tarlac and LORENS S. SIMEON
born on April 24, 2001 at Gerona, Tarlac;

2. That I am giving my consent for my children to renew their Passport to be

accompanied by their Father, RENATO SIMEON at the Department of
Foreign Affairs and to take charge all my responsibilities to my children;

3. That I am executing this affidavit to attest to the truthfulness of the

foregoing for the purpose of giving my consent as parent for the purpose of
the renewal of Passport of my minor children;

IN WITNESS WHEREOF, I hereunto set my signature this ___th day of

March 2017 at _______________.

MARILOU M. SOTTO
Affiant/Mother

SUBSCRIBED AND SWORN to before me this ____th day of March, 2017

at _______________.

Doc. No. ______;

Page No. ______;
Book No.______ ;
Series of 2017.
Republic of the Philippines)
Province of Tarlac ) s.s.
Municipality of Gerona )

AFFIDAVIT OF CONSENT

That I, MARILOU M. SOTTO, of legal age, Filipino and a resident of Brgy.

Poblacion 2, Gerona, Tarlac after being duly sworn to in accordance with law do
hereby deposes and states:

4. That I am the mother of the minor children namely: JULIE ANN S.

SIMEON born on July 8, 1999 at Gerona, Tarlac and LORENS S. SIMEON
born on April 24, 2001 at Gerona, Tarlac;

5. That I am giving full consent for my children to stay with their grandmother,
ILUMINADA S. SIMEON, with address at No. 89 Bel Mar Avenue, Daly
City, California, U.S.A and to take charge all my responsibilities to my
children;

6. That in lieu of a Special Power of Attorney, I hereby appoint and delegate

their grandmother, ILUMINADA S. SIMEON as their guardian;

7. That I am giving my guarantee that they will not violate any laws, rules and
regulations of the said country during their stay;

8. That I am executing this affidavit to attest to the truthfulness of the

foregoing for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set our hands this ___th day of
March, 2017 at ___________________, Philippines.

MARILOU M. SOTTO
Affiant/Mother

SUBSCRIBED AND SWORN to before me this ____th day of March, 2017

at ___________________, Philippines.

Doc. No. ______ ;

Page No. ______ ;
Book No.______ ;
Series of 2017.