AFFIDAVIT OF SUPPORT FOR VISA ISSUANCE

REPUBLIC OF THE PHILIPPINES )

_____________________________ ) SS.

I, (name of affiant), Filipino, of legal age, single/married to (name of spouse), and a

resident of (address of affiant), after having been duly sworn in accordance with law,
hereby depose and say:
1. That I am the of the ;
2. That I am accompanied by my , _.
3. That I guarantee any expenses that the above individual/s would incur.
This affidavit is being executed to the foregoing and in connection with our request to the
Department of Justice for issuance of Special Non-Immigrant
(47a2) Visa of the above-mentioned individuals here in the Philippines.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ____day of
____________ 20___ at ____________, Philippines.
_________________________________
(Signature of Affiant over Printed Name)

SUBSCRIBED AND SWORN TO before me, a notary public in and for

_____________________ this ____ day of ____________ 20___. The affiant, whom I
identified through the following competent evidence of identity: (ID type and number),
valid from (date) to (date) issued by (issuing authority), personally signed the foregoing
instrument before me and avowed under penalty of law to the whole truth of the contents of
said instrument.
Notary Public

Doc. No. ........;

Page No. .......;
Book No. .......;
Series of 2010.