AFFIDAVIT OF RENUNCIATION OF ALLEGIANCE

TO THE UNITED STATES OF AMERICA AND RENUNCIATION

OF AMERICAN CITIZENSHIP

That I, FRANCIS FREDERICK DEPASUCAT PALANCA, Filipino, of legal age,

and currently residing at Salvacion St. Brgy 6, Victorias City, Negros Occidental,
Philippines, after having been duly sworn to in accordance with the law, hereby depose
and state that I am expressly, unequivocally, and voluntarily renounce my American
nationality and citizenship, along with any ancillary rights, privileges and duties,
allegiances, or fidelity thereunto pertaining, I make this renunciation institutionally,
voluntary of my own free will and according, free from duress or undue influence with
full knowledge of the consequences.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of

______________ 2018 at Bacolod City, Philippines

FRANCIS FREDERICK DEPASIUCAT PALANCA

AFFIANT

SUBSCRIBED AND SWORN to before me this __ day of _______________ 2018,

affiant exhibiting to me his Philippine Passport No. P569122A, containing the affiant’s
photograph and signature, expiring on the 16th of January 2028 issued by the
Department of Foreign Affairs, Manila.

NOTARY PUBLIC

ATTY. JOHN MARK B. RELIQUIAS

NOTARY PUBLIC FOR THE CITIES OF BACOLOD,
TALISAY,
MUN. OF MURCIA AND DON SALVADOR BENEDICTO,
NEG OCC.
NP NO 0100-19 UNTIL DEC 31, 2019
PTR NO. 7471649 – 07/17/18 BACOLOD CITY
Doc. No. ____ IBP NO. 039660 – 05/08/18 NEGROS OCCIDENTAL
ROLL OF ATTORNEY’S NO 71241
Page No. ____ MCLE GOVERNMING BOARD ORDER SERIES OF 2008
BARBASA-ALBA VERDEFLOR GATANELA LAW FIRM
Book ____ RM 2. LD CENTER 7TH LACSONT STREET BACOLOD CITY
Series of 2018 TEL NO. (034)435-5212