REPUBLIC OF THE PHILIPPINES)
City of Manila ) S. S.
AFFIDAVIT OF SUPPORT AND CONSENT
I, MARISSA CRUZ LAGRMAS, of legal age, Filipino Citizen, Married with
residence address at No. 2444, Gapan Street, Gagalangin Tondo, Manila, after
having been duly sworn to in accordance with law, do hereby depose and state:
1. That I am the Parent of Mico Ruiz C. Lagrimas born on June 28, 1988
in the Manila;
2. That I and my Husband, Renato Lagrimas, the Father of Mico Ruiz C.
Lagrimas are giving out consent for our child to be accompanied by my Sister, Ms.
Annabelle F. Cruz;
3. That my sister Carmelita F. Cruz who works in Macau is sponsoring
their trip;
4. That we guarantee that they will not violate any existing laws of their
stay in the country of destination; and
5. That execute this Affidavit in connection with my child’s application
for a passport at the Department of Foreign Affairs and/or travel from the
Department of Social Welfare and Development for his Travel abroad.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 9th day of
December 2014 at the City of Manila, Philippines.
MARISSA CRUZ LAGRIMAS
Affiant
SUBSCRIBED and SWORN to before me this 9th day of December
2014, Affiant, exhibiting to me her Social Security System ID No. 33-0184923-9
issued by the SSS Main Office, Quezon City and PhilHealth Card no. 19-
050404962-4 issued by the PhilHealth Office, Binondo Office, Manila. . .
NOTARY PUBLIC
Doc. No. _______
Page No. _______
Book No. _______
Series of 2014