REPUBLIC OF THE PHILIPPINES) 

CITY OF MANILA )S.S. 

 
 
DECLARATION OF INTENTION 
 
 
I, Wang Liyin, do declare on oath that : 
 
 
It is my intention in good faith to become a citizen of the Philippines and 
to permanently reside therein; 
 
My  full  name  is  :  ______________________  otherwise  known  as  CHARLES 
TAN. 
 
My age is _______, and my occupation is businessman. I am married. 
 
My  wife’s  name  is  ___________________  ​aka  _____________________,  who 
was  born  in  __________________  on  _________________  and  now  resides  at 
________________________________, Roxas Boulevard, Pasay City. 
 
I have children – ________________ who was born on _____________________ 
and _______________________ who was born on ________________________ both in 
Manila and now resides with us at __________________________. 
 
My  personal  description  is  :  racial  color,  fair;  complexion,  fair;  height, 
5’4”; weight, 140 lbs; color of hair, black; color of eyes, black. Two photographs 
of myself are hereto attached, duly signed and autographed by me. 
 
I  was  born  in  China  on  _______________________.  I  now  reside  at 
________________________,  Roxas  Boulevard,  Pasay  City  and  my  present 
post-office address is ____________________________________. 
 
My last foreign residence was __________. 
   
 
 
 
 
I  emigrated  to  the  Philippines  from  Hong  Kong/China  and  arrived  on 
plane  flight  in  ______________and  has  been  issued  all  necessary  papers  and 
documents by the Bureau of Immigration for permanent residence. 
 
I will, upon being admitted to the Philippine citizenship, renounce forever 
all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, 
and particularly to China, of which at this time I am a citizen or subject. 
 
I  am  not  an  anarchist;  I  am  not  a  polygamist  nor  a  believer  in  the 
practice  of  polygamy;  I  have  not  been  convicted  of  any  crime  involving  moral 
turpitude;  I  am  not  suffering  from  any  incurable  disease.  I  have  mingled 
socially with the Filipinos and I have learned to love and embrace the customs, 
traditions, and ideals of the Filipinos. 
 
I believe in the principles underlying in the Philippine Constitution. 
 
So help me God. 
 
 
______________________________________ 
​WANG LIYIN ​aka ​__________________ 
Declarant 
 
 
SUBSCRIBED AND SWORN to before me on _____________________ in the 
City  of  Manila,  the  declarant  being  personally  known  to  me  and even showed 
his Driver’s License as competent proof of identity. 
 
Doc No.______ 
Page No._______ 
Book No._______ 
Series of 2018