Affidavit To Return Home

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REPUBLIC OF THE PHILIPPINES )

BINANGONAN RIZAL ) S.S.


x----------------------------------------------x

AFFIDAVIT TO RETURN HOME

I, LINDSAY DIEGO LIBIRAN, of legal age, Filipino Citizen, single and presently residing at 1202
Venus St., Constellatin Homes, Brgy. San isidro, Angono, Rizal, after been duly sworn in accordance
with the law, do hereby depose and state:

1. That, I am committed to come back within the legal stay granted by authorities as I have moral
obligation/responsibility towards our community, my family, my business, and transactions left here in the
Philippines and further guarantee that I will not, in any manner become a burden to the Philippines and
New Zealand government;

2. That, I will only stay in the Netherlands for the number of days allowed by the Netherlands
Immigration Authorities, and I will not become an illegal immigrant in the Netherlands, and other
Schengen Member States;

3. That, I will leave the territory before my visa expires and I will abide the law; That, I fully
understand and know the consequences if I disobey the rules both in the Netherlands and Philippines;

4. That, I intend to travel to Bangkok, Thailand on November 20 to November 25, 2023, after I
return home from the Netherlands;

5. That, I look after my sister and grandfather in The Philippines, and so I shall return home;

6. That, I am executing this Affidavit to attest to the truth of the following facts, for the application
of my Visit Visa, for the assurance that I will return to the Philippines, and for all legal intents and
purposes it may serve.

IN WITNESS WHEREOF, I am affixing my signature this ______ day of ______, ______ at


____________________________, Philippines

CHELSEA ANDRE PEREZ GARING


Affiant

SUBSCRIBED AND SWORN TO before me this _____ day of _______, ________ at __________.

Doc. No.__________
Page No.__________
Book No.__________
Series of 2023

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