REPUBLIC OF THE PHILIPPINES)

CITY OF DUMAGUETE ) S.S.

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AFFIDAVIT OF CONSENT

I, VICTORIANO D. CALDERON, JR, of legal age, married, Filipino, and a resident of

Poblacion, Tayasan Negros Oriental, after having been duly sworn to in accordance with law, do
hereby depose and state that:

1. I am the father of VIJE RHANIER T. CALDERON, who is applying for a Student

Driver’s Permit at the Land Transportation Office (LTO);

2. I am giving my full consent to my said child in support of his application for a Student
Driver’s Permit;

3. There is no criminal case pending in court against him nor has he been charged of
subversion, rebellion or insurrection in any Court of the Philippines;

4. I am executing this Affidavit to attest to the truth of the foregoing as to my undertaking to

give consent to my son’s application for a Student Driver’s Permit, and for whatever
legal purposes this may serve best.

In witness whereof, I have hereunto set my hands this _____________, Dumaguete City.

VICTORIANO D. CALDERON, JR.

Affiant
Proof of Identity: Driver’s License
I.D. No.: G08-07-001927
Valid Until: 2022/06/23

SUBSCRIBED AND SWORN TO BEFORE ME, this _________________, Affiant

personally appeared and exhibited to me his competent proof of identity and acknowledged that
the abovementioned Affidavit of Consent is executed by him voluntarily.

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Series of 2021.