REPUBLIC OF THE PHILIPPINES )

CITY OF IMUS )

AFFIDAVIT OF SUPPORT

I, _____________, Filipino, of legal age, with residence address at

_________________________ after having been duly sworn to in accordance with
law, hereby, depose and say that:

1. That I am the _____________ of _______________Filipino, of legal age,

with residence at ________________________ and who is senior citizen
currently without any means of providing for her daily needs;

2. That as her ____________I am willing to extend my whole hearted support

and responsibility towards my_____________ and that I have the financial
capability to provide all of her needs by giving _________________

3. I execute this affidavit to attest to the truth and veracity of the foregoing
statements, as evidence of my support towards my sister, and for all intents
and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________

in _____________, Cavite, Philippines.

VIRGINIA S. LADNER
affiant

in conforme:

__________________________

SUBSCRIBED AND SWORN to before me at the place and date above

stated. I hereby certify that I personally examined the affiant and am convinced that
she voluntarily executed the foregoing affidavit, read the same and understood it
contents.

Doc. No. ______; NOTARY PUBLIC

Page No. ______;
Book No.______;
Series of 20__