The Consular Section of the Philippine Embassy in Tokyo, Japan assumes no responsibility for the contents of this document

as written by the applicant.

AFFIDAVIT OF SUPPORT, GUARANTEE AND CONSENT

(Sinumpaang Salaysay ng Pahintulot, Garantiya at Pananagutan)

Ako, si__________________________________________________________, mamamayang Pilipino,

I, (Name/ Pangalan) citizen of The Philippines,

kasalukuyang________________________________________, may sapat na gulang at wastong pag-iisip, na

(dalaga/binata/kasal/balo/diborsyado/napawalang-bisa ang kasal), of legal age and sound mind,

kasalukuyang nakatira sa ___________________________________________________________

presently residing at (Address in Japan/ Tirahan sa Japan)

matapos manumpa sang-ayon sa batas, ay malaya at kusang-loob na nagsasabi:

after having been sworn in accordance with law, do hereby depose and say:

(1) Na aking inaanyayahan ang mga sumusunod upang makasama ko sa Japan:

That I have invited the following person(s) to visit us in Japan:

Pangalan / (Complete Name) Ugnayan/ (Relationship) Edad /(Age)

_________________________________ ____________________ __________

_________________________________ ____________________ __________

_________________________________ ____________________ __________

_________________________________ ____________________ __________

(2) Na aking pinahihintulutan ang mga taong nabanggit na maglakbay mula ________ patungong___________,
That I am giving my full consent for the abovementioned individuals to travel from to

ng walang kasama,
Alone and unaccompanied

kasama si ______________________________________ na siya kong _______________,

accompanied by (Name/ Pangalan) who is my (ugnayan/relation)

kung saan sasalubungin sila sa airport/ may sariling transportasyon para makapunta sa kanilang tutuluyan sa
where arrangements (to meet them at the airport / for transport accommodations) have been made to their living accommodations at

_____________________________________________________________________________,
(Address in Japan/ Tirahan sa Japan)

(3) Na aking sinisiguro ang kanilang pagtupad sa lahat ng batas at alituntunin ng bansang_________________.
That I guarantee the abovementioned person(s) shall abide by all the laws and regulations of (country of destination)

at batid ko at inaako ang lahat ng responsibilidad at pananagutan, kasama ang lahat ng gastusing pinansiyal sa
kanilang paglalakbay at pananatili dito.
and I hereby accept and assume any and all responsibility for their welfare, including all financial expenses related to their travel and stay.

Bilang patunay sa lahat ng ito, ako ay pumirma ngayong ika- _____________,dito sa Tokyo, Japan.
In witness whereof, I have hereunto affixed my signature this (petsa/date) , in Tokyo, Japan

Affiant’s Signature/ Pirma ng Nagsasalaysay

ID/ Passport No:_______________________________
Expiration Date: _______________________________
Issuing Authority: ______________________________