REPUBLIC OF THE PHILIPPINES)

CITY OF ________________ ) S.S.

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

I, _________________, of legal age, Filipino, single, 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. Not knowing that passport claiming has a deadline, I procrastinated and I failed to
claim my passport on the above-mentioned date;

4. Sometime in ______________, I decided to finally claim the said passport because I

need to travel to _________________;

5. However, a female releasing officer at _____________ told me that

___________________

6. Thus, I reapplied for passport renewal, 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 affivadit 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.

____________________

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 2017.