Affidavit Of Support

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AFFIDAVIT OF SUPPORT
KNOW ALL MEN BY THESE PRESENTS:
That I/We,_________________________________/________________________________ of legal age(s)
(name of applicant/s)
single/married/widower/separated and resident of________________________________________,
(address in Ireland)
after being sworn to according to law hereby depose and state that:
1) _____________________________ /____________________________/____________________________
(name(s) of dependent(s)/and/or relative(s)
is my/our __________________________ and ______________________ respectively who is at present
(relationship)
(relationship)
_______________________________________________________________________;
residing at
(residence address)
2) I/We am/are employed by __________________________________________________________________
(name and address of employer)
as a _____________________ with a monthly salary of ______________________;
(position)
3) By virtue of these presents, I/we hereby attest that I/we will support him/her/them during his/her/their
stay/visit with me/us in the Ireland and shall not be a public burden in any way should a visa be granted to
him/her/them;
4) He/She/They will actually live with me/us at the above-mentioned address while in ________;
and
5) I/We am/are executing this affidavit in connection with his/her/their exit from the Philippines to Ireland
Affiant/s further sayeth naught.
IN WITNESS WHEREOF, I/we have hereunto signed this Affidavit this _____ day of __________________ 20___ at
___________, Ireland.
___________________________
___________________________
(affiant’s signature)
(affiant’s signature)
Philippine/___________ Passport No. __________
Philippine/_________ Passport No. __________
Date of Issue _______________
Date of Issue _______________
Place of Issue _______________
Place of Issue _______________
)
SUBSCRIBED AND SWORN to before me this ______ day of ______________________ 20___, in the City of
_________ , Ireland, affiant/s exhibiting his/her/their Passport/s.
Doc. No. :____________
Serv No. :____________
O.R. No. :____________
Fee paid :____________
This form was revised 04/2013 – Consulate of the Philippines, Dublin This form is not for sale and can
be reproduced

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