REPUBLIC OF THE PHILIPPINES )
_______________________________, _______________________________ ) S.S.

AFFIDAVIT OF SUPPORT WITH UNDERTAKING

I, ________, of legal age, with the following nationality: Filipino, single, presently residing at: ________, after having been duly sworn to in accordance with law, do hereby depose and state that:

1. I am currently employed with the position of: ________, employed at: ________, with business address at: ________;

2. I am currently earning a monthly income of: ________;

3. I am inviting my spouse: ________, to visit me in ________;

4. ________ was born on: ________ at: ________, and is currently residing at ________;

5. ________'s passport number is: ________;

6. ________ will be staying with me at my home in ________;

7. I will likewise pay for all travel expenses of ________ during their stay in the following country: ________;

8. I guarantee that ________ shall not be a public charge in the following country: ________;

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AFFIANT FURTHER SAYETH NAUGHT.

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________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at the City/Municipality of _______________________________ Province of _______________________________, personally appeared:

affiant, ________, personally appeared before me and exhibited to me the following competent proof of identity: _______________________________________________________________.

Doc. No.: _________
Page No.: _________
Book No.: _________
Series of _________