Affidavit of Delayed Registration of Birth

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AFFIDAVIT OF LATE REGISTRATION OF BIRTH

We, _______________________________ and _____________________________, both of legal age, married,


Filipino Citizens, and presently residing at ____________________________________________ after having been
sworn in accordance with law, hereby depose and state that:

1. We are the parents of, and the applicants for the delayed registration of the birth of our son,
____________________________________, who was born on ____________________________ at
____________________________________________;

2. We were married on ____________________________________________ at


____________________________________________; and our son was born during such marriage;

3. The reason for the delay in registering our son’s birth was
__________________________________________________________________________________________________________
________________________________________________________________________________________________________.

4. We are executing this affidavit to attest to the truth and veracity of the foregoing facts and in
compliance with the requirements of the Philippine Civil Registrar and the Philippine
Consulate.

IN WITNESS WHEREOF, we hereby sign this Affidavit this _____________________ at New York,
NY, U.S.A.

____________________________________ ____________________________________

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