PARENTAL TRAVEL PERMIT

I_________________________________________________of legal age, ____________

(status)
_______________________, and a resident of _______________________________________
(citizenship)
and with telephone # _____________ Passport No. _________________________, after
having been duly sworn to in accordance to law do hereby depose an say:
1. That I am biological mother/ father and/ or person exercising parental authority of
minor _____________________________________________born on _____________
and residing in __________________________________________________________.
2. That my child will travel to ________________________________________________
for ___________________________________________________________________.
3. That said will be leaving on __________________ and will stay in _________________
(date)
_________________________________________ for a period of ________________.
(address)
And will be taken cared of by _____________________________________________.
4. That I cannot personally travel with my child/ children due to _____________________
_______________________________________________________________________.
5. That I am giving my full consent to the travel of the aforementioned child abroad and to
be accompanied by my spouse ______________________________________________.
6. That this affidavit was executed for the purpose of attesting to the truth of the facts
above stated and for whatever legal purpose it may serve.
AFFIANT FURTHER SAYETH NAUGHT.
Signature of Affiant Over Printed Name
SUBSCRIBED and Sworn to before me this ______________________ day of
________________________________, in the City of ______________________.