REPUBLIC OF THE PHILIPPINES )

Municipality of Cainta, Rizal ) S. S.

AFFIDAVIT OF CONSENT

We, ___________________________ and ____________________________ both of legal age, married,

Filipino and residents of _________________________________________________________________ and with
tel. no. _______________, after having been duly sworn to in accordance with law do hereby
depose and state:

1) That we are the parents of _______________________________________ who was born on

___________________________ in ___________________;

2) That our son will travel to ________________ to attend the

_____________________________________ in _____________________________ for a period of six (6)
days from ______________________;

3) That our son will be leaving on ___________________________________________ and will stay in

the said country in _________________________ at __________________________________________ ;

4) That we are giving our full consent for our son to travel abroad to be accompanied by
______________________________________________;

5) That we personally guarantee the financial support of the our son in the course of his
travel and stay outside the Philippines and further guarantee that he will not violate
any existing laws of ___________________; and

6) That this affidavit was executed for the purpose of attesting to the truth of the
foregoing facts and for whatever legal purpose it may serve in connection with our
son’s application for travel clearance from the Department of Social Welfare and
Development.

IN WITNESS HEREOF, I hereunto set my hand this ____________ in Cainta, Rizal.

______________________ _____________________
Father Mother

SUBSCRIBED AND SWORN TO before me this ______day of ___________ in ______________.

Doc. No. ____________

Page No. ____________
Book No. ____________
Series of ____________
O.R. No. ____________