REPUBLIC OF THE PHILIPPINES )

CITY OF PASIG ) S.S.

AFFIDAVIT OF CONSENT AND SUPPORT

I, GERALDINE NORA S. AQUINO, of legal age, single, Filipino, and residing at No. 11-F
Intalan Street, Brgy. Bagong Ilog, Pasig City, after having been duly sworn in accordance with
law, hereby depose and state:

That I am the biological mother of JOHNSHEM MARL A. AZURIN, JARED BRAX A.

AZURIN and JOIRA BERLINA A. AZURIN, who are all minors and applying for a
Philippine Passport at the Department of Foreign affairs (DFA), Robinson’s Galleria
Office;

That I am giving my full consent to my children in their application for a Philippine

Passport to be used in their travel abroad;

That for this purpose, I have sufficient and adequate financial capacity to support and
defray the said travel and do hereby undertake to finance their trip abroad from the
application fees, airline tickets, board and lodging, pocket money and such other
expenses that they may incur so that they would neither be a burden to the state
nor at their place of destination at any time during their trip abroad;

That further, my children, JOHNSHEM MARL A. AZURIN, JARED BRAX A. AZURIN and
JOIRA BERLINA A. AZURIN will be accompanied by their biological father, ENGR.
RAYFIELD ZIGGY F. AZURIN, in their travel abroad;

That I am hereby giving my full consent to the said ENGR. RAYFIELD ZIGGY F. AZURIN to
accompany my children in their travel abroad;

That I am executing this affidavit to declare the truth of the foregoing facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set our hands this _____ day of August, 2013 at
__________, Philippines.

GERALDINE NORA S. AQUINO

AFFIANT

SUBSCRIBED AND SWORN to before me this _____ day of August, 2013 at Manila City,
Philippines. Affiant is personally known to me and was identified by me through Competent
Evidence of Identity as defined by the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC).
Affiant exhibited to me her Passport, with her photograph and signature appearing thereon,
with no. EB8223580 issued by DFA-NCR CENTRAL and which will expire on May 26, 2018.

Doc. No.
Page No.
Book No.
Series of 2013.