**[Your Name]**
**[Your Address]**
**[City, State, Zip Code]**
**[Phone Number]**
**[Email Address]**
**Date:** [Insert Date]
**To Whom It May Concern:**
I, [Your Name], of legal age, residing at [Your Address], being duly sworn, depose and state the following:
- I am a United States citizen holding a valid U.S. passport, passport number [Insert Passport Number], issued on [Issue Date] and expiring on [Expiration Date].
- I recently traveled to [Ksenya/Name of the Country/Region], departing on [Departure Date] and returning on [Return Date]. My travel was for [purpose of travel, e.g., tourism, business, etc.]. During my stay, I [describe briefly what you did, if relevant].
- I am currently applying for a visa to travel to the People’s Republic of China. As part of the visa application process, I am required to provide information regarding my recent travels.
- I affirm that during my visit to [Ksenya/Name of the Country/Region], I complied with all applicable local laws and regulations and have not engaged in any activity that would be contrary to the requirements for a visa to China.
- I hereby affirm that all information provided in this affidavit is true and correct to the best of my knowledge and belief.
- I understand that any false statement made in this affidavit may result in the denial of my visa application or other legal consequences.
I am making this affidavit to assist in my application for a visa to China and for no other purpose.
**[Signature]**
**[Your Name]**
