REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI )S.S

AFFIDAVIT OF EXPLANATION

I, ______________________________, of legal age, Filipino, single/married, and

with residence address at ______________________________, after having been duly sworn
to in accordance with law, do hereby depose and state:

That I am a holder of a Philippine Passport No.____________ issued on _______ and

expired on ____________;

Unfortunately, I stated on the said Passport that my marital status was single which
was a mere mistake by registration;

That I used the marital status as single because we are ____ years separated and
estranged from her for a long time;

That I hereby certify that the said separation was made without a court decision and I
no longer have contact with her since our separation;

Furthermore, the said Passport was lost due to unavoidable circumstances when it was
held by my employer from Kuwait;

With the help of the Philippine Consulate in Kuwait, I manage to travel back to the
Philippines without the said Passport and by using travel documents only in lieu of the said
held Passport;

That I hereby attest that the said Passport was never used as security to any obligation
or transaction and was not been encumbered, sold, pledged, assigned, alienated, or given as
collateral for any debt or obligation to or in favor of any person or entity;

That I am executing this affidavit of explanation to inform the DFA regarding the
whereabouts of my passport and to request for a new passport in LIEU of the one that was
with held by my employer;

That I would like to request to change my single status to marital status hence, I am
married to _____________________ even we’re separated, I don’t want to result, arise, or
accrued any present problem;

Finally, that I am executing this affidavit to attest to the truth of the foregoing facts,
and veracity of the foregoing statements in order to inform the proper authorities concern and
for whatever legal intents and purposes this may serve;

IN WITNESS WHEREOF, I have hereunto set our hand this ____ th day of ______,
2022 at the City of Makati, Philippines.

__________________________________
AFFIANT
 SUBSCRIBED AND SWORN to before me t this ____ th day of ______, 2022 at the
City of Makati, and with affiant exhibiting her ____________________________

Doc No.__________
Page No._________
Book No._________
Series of 2022