Republic of the Philippines )

City of ___________ ) S.S.

x--------------------------------x

AFFIDAVIT OF EXPLANATION

I, ______________, of legal age, married, Filipinos, and a resident of XXX City,

Philippines, after having been duly sworn in accordance with law, hereby depose and state:

1. That I am applying for a Japan Visa and I am required to submit my Baptismal

Certificate and Form 137;

2. That I can no longer secure the said Documents because of certain calamities
which happened, that as a result thereof the church where I was baptized and the
school which I attended to cannot locate my records anymore;

3. That I am executing this Affidavit in order to establish the truth of the foregoing
facts and to attest to the veracity of the same and for the purpose of supporting the
requirements for the issuance of my visa and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hands this 16th day of February
2015 at XXX City, Philippines.

XXXXX
AFFIANT

SUBSCRIBED AND SWORN to before me this ______________at Bacolod

City, Philippines. Affiant exhibited to me her Philippine Passport with no.
__________issued on ____________at _______________.

NOTARY PUBLIC

Doc. No._____
Page No. _____
Book No. _____
Series of 2015