Republic of the Philippines )

Surigao City ) S.S.

AFFIDAVIT OF CONSENT

I, TERESITA P. LOCA, of legal age, married, Filipino and a resident of Brgy. Luna,
Surigao City, SDN, Philippines, having been duly sworn in accordance with law, hereby depose
and state:

1. That I am the mother of AMIEL ALIE P. LOCA, 15 years old, who is applying for a
Student Driver's Permit at the Land Transportation Office (LTO);

2. That I am giving my full consent to my said son in his application for a Student
Driver's Permit;

3. That there is no criminal case pending in court against him nor has he been charged of
subversion, rebellion or insurrection in any court of the Philippines;

4. That I am executing this affidavit to declare the truth of the foregoing facts as to my
undertaking to give consent to my son's application for Student Driver's Permit.
 
IN WITNESS WHEREOF, we have hereunto set our hands this 25th February 2013 at
Surigao City, Philippines.

TERESITA P. LOCA
Affiant

SUBCRIBED AND SWORN, to before me this 25th day of February 2013 at the Surigao
City, Philippines.

ATTY. GRACIANO C. COMPE, JR.

Public Attorney II
(Pursuant to R. A. No. 9406)