Affidavit To Use The Surname of The Father

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RA 9255

REPUBLIC OF THE PHILIPPINES)


PASIG CITY ) s.s. Registry No. ___________

AFFIDAVIT TO USE THE SURNAME OF THE FATHER

I, __________________________ of the age ___________ and a resident of


_____________________________ under oath, allege;

1. That I am biological father of _______________________________ ;

2. That the biological mother of my child is ______________________ ;

3. That my child ___________________________________ was born on


__________________ at ________________________, under Reg. No.
__________________;

4. That the fact of my child _____________________________ were duly


Registered at the Office of the Civil Registry of _________________ ;

5. That I, _____________________________________, being the father of


______________________________ hereby acknowledge and recognize
him /her child and legal heir/s;

6. That I am allowing my child ____________________________ to use my


surname _________________________, to his/her surname in his/her
certificate to live birth, school records and legal undertakings;

7. That my child shall be known as _______________________________ ;

8. That I execute this affidavit to attest the truth of the above facts for whatever
legal intents and purpose it may serve and in compliance with the provision of
Republic Act. 9255.

IN WITHNESS WHEREOF, we have hereunto affixed our signatures this


____________ day of ____________ 2017 at _______________.

_______________________________ ____________________________
Signature over printed name of mother Signature over printed name father

SUBSCRIBED AND SWORN to before me this _________________ day of


__________ 2017 in the City of Pasig, Community Tax Certificate No. ____________
Issued at _____________ on ____________.

Doc. No. _________


Page No. _________
Book No. _________
Series 2017.
REPUBLIC OF THE PHILIPPINES)
PASIG CITY )s.s.

AFFIDAVIT OF PATERNITY

I, ________________________, of legal age, Filipino, with residence address at


_____________________________after having been duly sworn to in accordance with
law, hereby depose and say;

1. That I, am the natural father of ______________________ who was born on


_______________________ at Pasig City;

2. That the facts of my son / daughter birth certificate were duly registered at the
Office of the Local Civil Registry of _____________________________in such
surname ________________ for her mother and were not yet married;

3. That I, herby acknowledge that I am biological father of


______________________;

4. That I am executing this affidavit to attest the truth of the foregoing statements
and for whatever legal purpose, it may serve;

5. Further, affiant sayeth none;

IN WITHNESS WHEREOF, I have hereinto set my hand this _________ day of


_____________ at ______________.

__________________________
Affiant

SUBCRIBED AND SWORN to before me this __________________ day


of ______________ in the City of Pasig.

Doc. No. _________


Page No. _________
Book No. _________
Series 2017

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