REPUBLIC OF THE PHILIPPINES

Province of Negros Occidental)S.S.

City of Bacolod)

AFFIDAVIT OF EXPLANATION

I, ROSEMARIE BAYLEN LAMES, of legal age, single, Filipino, with residence

at Purok Baluarte, Barangay Alegria, Murcia, Negros Occidental, after having been
duly sworn to in accordance with law, do hereby depose and state the following:

1. That I am scheduled to travel to Japan on December 7, 2017, under a

tourist Visa;

2. That one of the supporting documents required for the issuance of Tourist
Visa is my Form 137;

3. That upon notice that the said document is required to be submitted, I

processed the same immediately;

4. That despite diligent efforts to secure the said document and for reasons
beyond me, the same cannot be produced before December 7, 2017;

5. That the Registrar’s Office of St. Joseph School La Salle Bacolod, notified
me that the processing and issuance of the Form 137 will take
approximately three (3) to four (4) weeks;

6. That the foregoing is the reason why I cannot secure and submit the Form
137 before December 7, 2017;

7. That I am executing this affidavit to attest to the truth of the foregoing

and for whatever legal purposes that this statement may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this 14th day of

November, 2017, in the City of Bacolod, Philippines.

ROSEMARIE BAYLEN LAMES

AFFIANT

SUBSCRIBED AND SWORN to before me, this 14th day of November, 2017,
by ROSEMARIE BAYLEN LAMES, who exhibited to me her PhilHealth ID (11-
251639342-7) issued at Bacolod City, Philippines.

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Series of 2017