REPUBLIC OF THE PHILIPPINES )

CITY OF ANTIPOLO ) S.S.

AFFIDAVIT OF EXPLANATION
(NON-DECLARATION OF UNCLAIMED PASSPORT DURING APPLICATION FOR RENEWAL)

I, , of legal age, Filipino, married, and presently residing at ____________ after having
been duly sworn to in accordance with law, depose and state that:

1. I was issued my first passport with _____________ sometime in _______________;

2. After it expired, I applied for passport renewal in ________ sometime in ________,

and my new passport with ____________ was scheduled for release on
________________;

3. I was working as a maid in ____________________ and my bosses needed to go to

Egypt immediately. Stayed in Egypt for ________ and had no way to go back
_________________ to claim my new passport.

4. As I was in Egypt, my father died on ______________ and I flew in haste to the

Philippines to attend his burial.

5. Due to these circumstances, I failed to claim my passport from the said place;

6. I reapplied for passport renewal in _____________, however, I failed to indicate in

my application that I have an unclaimed passport as there was no instruction for me to
do so;

7. My reapplication was granted and the new passport was set to be released on
_________________;

8. But, on even date, a certain __________________________.

9. I then explained to _________________ the circumstances surrounding my two

passport application, and she told me to prepare an affidavit to such effect – thus this
affidavit;

10. I executed this Affidavit to attest to the truth I mentioned herein and for whatever
legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _______________ in

__________________, Philippines.

__________________________
XXXX

SUBCRIBED AND SWORN TO before me this _______________ in _______________,

Philippines, affiant exhibiting to me her valid proof of identification.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2019.