Republic of the Philippines)

______________________ )S.S.

AFFIDAVIT OF SUPPORT

I, _____(name)______, a permanent resident of _____(permanent

address)_____, was born on _____(date of birth)_____in _____(place of birth), do
hereby declare the following:

1. That my son/daughter, _____(name of child)_____, _____(gender of

child)_____, _____(age of child)_____, born in _____(place of birth)_____
on _____(date of birth)_____, has been accepted as an exchange student
(non-degree status) from _____(date of start to end of the exchange) _____
at the Ateneo de Manila University located at Loyola Heights, Quezon
City, under the Ateneo de Manila - ____(your home school)_____________
student exchange program.

2. That as of _____(state date)_____, I have a deposit of _____(state

amount)_____ with _____(state the name of the bank) _____, under the
bank account number _____(state account number)_____.

3. That I shall be fully responsible for all his/her financial, educational and
living expenses during his/her stay in the Philippines.

4. I affirm that I know the contents of this affidavit signed by me and the
statements are true and correct.

AFFIANT

Subscribed and sworn before me on this ____day of ____(month)____,

2009 at _____(state place)_____.

SUBSCRIBED AND SWORN to before me this _______________ day of June 2009 at Makati
City, affiant exhibited to me his Passport No. XD205832 issued at C.G. Manila on October 17,
2007.

NOTARY PUBLIC

Doc. No. ______

Page No. ______
Book No.______
Series of 2009.