CONSULATE GENERAL OF THE PHILIPPINES)
CITY OF LOS ANGELES
) S.S.
STATE OF CALIFORNIA, U.S.A
)
AFFIDAVIT OF IDENTITY
After having been duly sworn to in accordance with law, I hereby depose and say
that:
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1) ________________________________I.D. with number ___________________
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issued on ____________________ at _________________________________
insert complete name written on identification card 1
indicating the name of __________________________________________; and
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2) ________________________________ I.D. with number __________________
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issued on ____________________ at _________________________________
insert complete name written on identification card 2
indicating the name of ______________________________________________
indicates both one and the same person.
3) I am executing this Affidavit to attest to the truth and for whatever legal purpose it
may serve.
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IN WITNESS WHEREOF, I hereby affix my signature this _________ day of
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____________________, 20______ at the Philippine Consulate General, Los Angeles,
place you signed this affidavit
California, U.S.A.
name of affiant over signature
____________________________
(Affiant)
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SUBSCRIBED AND SWORN to before me this _______ day of _____________,
20______ at the Philippine Consulate General, Los Angeles, California, U.S.A.
___________________________
Vice Consul / Consul
Philippine Consulate General
Los Angeles, CA, U.S.A