Affidavit of Consent and Support - Template Form

AFFIDAVIT OF CONSENT AND SUPPORT

(For Travel and Passport Application of a Minor Child)

REPUBLIC OF THE PHILIPPINES )
CITY/MUNICIPALITY OF ________ ) S.S.

I, ________, Filipino, of legal age, ________, with ________ bearing No. ________, and a resident of ________, after having been duly sworn to in accordance with law, do hereby depose and state THAT:

1. I am the natural/legitimate mother of ________, a minor, ________ years of age, born on ________ at ________, as evidenced by his/her Certificate of Live Birth issued by the Philippine Statistics Authority (the "Minor Child");

2. As the parent exercising parental authority over the Minor Child pursuant to Articles 209 to 211 of the Family Code of the Philippines (Executive Order No. 209, as amended), I have legal custody of and the right to consent to the travel of the said Minor Child;

3. The Minor Child is presently applying for the issuance of a Philippine passport with the Department of Foreign Affairs in accordance with Republic Act No. 8239, otherwise known as the "Philippine Passport Act of 1996," as amended;

4. I hereby freely and voluntarily give my full and unconditional CONSENT to the issuance of the said passport and to the travel of the Minor Child abroad, whether accompanied by me or by ________, to ________ on or about ________;

5. I undertake to be responsible for and to guarantee the welfare, safety, and well-being of the Minor Child during the entirety of the said travel;

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7. I hereby hold free and harmless the Department of Foreign Affairs and its officers from any liability that may arise in connection with the issuance of the passport and the travel of the Minor Child by reason of the foregoing consent;

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IN WITNESS WHEREOF, I have hereunto set my hand this ________ day of ________, 20________, at ________, Philippines.

AFFIANT FURTHER SAYETH NAUGHT.

________
Affiant

SUBSCRIBED AND SWORN TO before me this ________ day of ________, 20________, at the City/Municipality of ________, Province of ________, affiant ________ personally appeared before me and exhibited to me her competent evidence of identity in the form of ________ bearing No. ________ issued on ________ at ________, and who is personally known to me to be the same person who executed the foregoing instrument and acknowledged to me that the same is her free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date and at the place above written.

________
Notary Public

Until ________
PTR No. ________; Issued on ________ at ________
IBP No. ________; Issued on ________ at ________
Roll of Attorneys No. ________
MCLE Compliance No. ________

Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.