SPA and ASC For Minors

SPECIAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That I, ____________________________________, __________________ citizen, of legal age and

(first name, middle name, last name) (his/her citizenship)
resident of _____________________________________________________ do hereby appoint, name

(complete address)
and constitute ____________________________________, __________________ citizen, of legal age,

(name of representative) (his/her citizenship)
and resident of ______________________________________________________________________,

Philippines, to be my true and lawful attorney-in-fact/representative to act for and in my name and stead, and on my
behalf to do and execute any or all of the following acts, deeds, and things, to wit:
[ ] Accompany my minor child(ren)/ward(s) whose name/s below in applying for a Philippine Passport
at the Department of Foreign Affairs of the Philippines;
[ ] Apply P/ren’s/ward’s passport and visa applications.
Name(s) of my minor child(ren)/ward(s):
Name: ____________________________________________Birthday: _____________________
Name: ____________________________________________Birthday: _____________________
Name: ____________________________________________Birthday: _____________________
HEREBY GIVING AND GRANTING unto my attorney-in fact/representative full power and authority to execute and
perform every act necessary to render effective the special power granted in this instrument,as though I myself have
so performed it, and HEREBY APPROVING AND RATIFYING ALL that he may do by virtue thereof.
This special power of attorney shall be in effect-

for______________ month(s) / year(s)
until the completion of the object or purpose above-stated
until revoked
IN WITNESS WHEREOF, I have hereunto set my hand this ________________day of _____________,20_______

in_________________.
________________________________________
Principal
(Full Name and Signature)
Republic of the Philippines)
_____________________)S.S
BEFORE ME, personally appeared:
Name CTC Number Date/Place Issued
Known to me and to me known to be the same person who executed the foregoing instrument and acknowledged to
me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL, on the date and place first above written.
Doc. No.__ _________; Notary Public

Service No._________;
O.R No.____________;
Fee Paid___________;
Series of 20_________;
AFFIDAVIT OF SUPPORT AND CONSENT
I, _______________________________________________, Filipino, of legal age and presently residing

At ________________________________________________________________________________________
(full address)
After having been duly sworn to in accordance with law, hereby depose and state that:
1. I am the mother/ father/ court-appointed legal guardian of the following child(ren):
• _____________________________born on _____________________in _________________________
• _____________________________born on _____________________in__________________________
• _____________________________born on _____________________in__________________________
2. I am giving my consent for the said child(ren) to travel abroad accompanied by

________________________________________________________________________________________;
(name of accompanying adult)
3. I am paying for the expenses of their travel;
4. I am financially capable to provide for their accommodation, sustenance and support during their sojourn;
5. I guarantee that they will not violate any law of their destination country;
6. I guarantee this affidavit in connection with my child(ren)’s/ward’s application for passport at the Department of
Foreign Affairs and/or travel clearance at the Department of Social Welfare and Development for travel abroad.
IN WITNESS WHEREOF, I have hereunto signed my name this ____________day of _______________

at ___________________________________ Philippines.
(Embassy or Consulate, if abroad)
_________________________________
Affiant
(Full Name and Signature)
Republic of the Philippines)

__________________)S.S.
BEFORE ME, personally appeared:
Name CTC Number Date/Place Issued
Known to me and to me known to be the same person who executed the foregoing instrument and acknowledged to
me that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL, on the date and place first above written.
Doc.No.__________; Notary Public

Service No._______;
O.R. No._________;
Fee Paid_________;
Series of 20_______;

SPA and ASC For Minors

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SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, ____________________________________, __________________ citizen, of legal age and

resident of _____________________________________________________ do hereby appoint, name

and constitute ____________________________________, __________________ citizen, of legal age,

and resident of ______________________________________________________________________,

Name: ____________________________________________Birthday: _____________________

Name: ____________________________________________Birthday: _____________________

This special power of attorney shall be in effect-

IN WITNESS WHEREOF, I have hereunto set my hand this ________________day of _____________,20_______

Name CTC Number Date/Place Issued

Doc. No.__ _________; Notary Public

I, _______________________________________________, Filipino, of legal age and presently residing

1. I am the mother/ father/ court-appointed legal guardian of the following child(ren):

• _____________________________born on _____________________in _________________________

2. I am giving my consent for the said child(ren) to travel abroad accompanied by

3. I am paying for the expenses of their travel;

IN WITNESS WHEREOF, I have hereunto signed my name this ____________day of _______________

Republic of the Philippines)

BEFORE ME, personally appeared:

Name CTC Number Date/Place Issued

Doc.No.__________; Notary Public

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That I, __________________, citizen, of legal age and

and constitute __________________, citizen, of legal age,

Name: ________________________Birthday: _

Name: ________________________Birthday: _

IN WITNESS WHEREOF, I have hereunto set my hand this __________day of _,20_

Doc. No. _______; Notary Public

• ___________________born on _in _______________

IN WITNESS WHEREOF, I have hereunto signed my name this day of ___