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AFFIDAVIT OF SUPPORT AND CONSENT TO TRAVEL

I, FLORDELIZZA RAZON ABELLERA, of legal age, Filipino, married and presently residing at Tuy,
Batangas after having been duly sworn to in accordance with law, depose and state:

1. That I am the biological mother of Nicole D’lonreign Abellera Comia who was born on
November 07, 2003 in Batangas City;

2. That said child will to travel to Japan for tourism;

3. That I am giving my full consent for the minor child to travel abroad to be accompanied by
me;
4. That I personally guarantee the financial support of the child in the course of her travel and
stay outside the Philippines and further guarantee that she will not in any manner become a
burden to the Philippine and Japan governments.

5. That I am executing this affidavit in connection with my child application for a passport at the
Department of Foreign Affairs and/or travel clearance from the Department of Social Welfare
and Development for her travel abroad.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ of October 2015 in BALAYAN,
BATANGAS, Philippines.

Flordelizza R Abellera
Affiant
Philippine Passport No. EC4982607
Issued at: DFA Manila
Issued on: August 15, 2015

SUBCRIBED AND SWORN TO before me this ___________________ in BALAYAN, BATANGAS,


Philippines, affiant exhibiting to me her valid proof of identification.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2013.