AFFIDAVIT OF CONSENT

I,Yvonne P. Samson, Filipino, of legal age, single and a resident of Sitio Cyco Brgy.
Basak San Nicolas, Philippines, having been duly sworn in accordance with law,
hereby depose and state:

That I am the mother of Ateisha Nicole Samson Alberto, who is applying for a
Student Driver's Permit at the Land Transportation Office (LTO) and .

That I am giving my full consent to my said son/daughter in (his/her) application for a

Student Driver's Permit;

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

That I am executing this affidavit to declare the truth of the foregoing facts as to my
undertaking to give consent to my daughter's application for Student Driver's Permit.

IN WITNESS WHEREOF, we have hereunto set our hands this March 31, 2023 at
Sitio Cyco Brgy. Basak San Nicolas Cebu city, Philippines.

Yvonne P. Samson