REPUBLIC OF THE PHILIPPINES)

Province of _______________ __) S.S.

City/Municipality of __________ _)
x - - - - - - - - - - - - - - - - - - - - - - - x

AFFIDAVIT OF CONSENT

I, _____________, Filipino, of legal age, married and a resident of _____________, Philippines,
having been duly sworn in accordance with law, hereby depose and state:

That I am the father of _____________, who is applying for a Student Driver's Permit at the Land
Transportation Office (LTO);

That I am giving my full consent to my said (son/daughter) in (his/her) application for a Student
Driver's Permit;

That there is no criminal case pending in court against (him/her) nor has she been charged of
subversion, rebellion or insurrection in any court of the Philippines;

That I am executing this affidavit to declare the truth of the foregoing facts as to my undertaking to
give consent to my (son/daughter)'s application for Student Driver's Permit.

IN WITNESS WHEREOF, we have hereunto set our hands this _____________ at
_____________, Philippines.



AFFIANT

SUBSCRIBED AND SWORN to before me, this _____________, by the Affiant who is personally known to
me (or whom I have identified through competent evidence of identity) and who exhibited his/her
Community Tax Certificate No. _____________ issued at _____________ on _____________.




Notary Public




Doc. No. ______;
Page No. ______;
Book No.______;
Series of 20____.