Republic of the
Philippines )
City of _____________ ) S.S.
AFFIDAVIT OF LEGITIMATION
I, (NAME OF AFFIANT-FATHER), Filipino, of legal age, single/married, and a resident of (Place of Residence), after having been sworn to in accordance with law, hereby
depose and state:
1. That I am the biological parent of (NAME OF CHILD) who was born on November 28,
2003 at Datu Unsuan General Hospital, Isabela, Basilan per her
Certificate of Live Birth with Registry No. 2003-65389 attached hereto and
forming an integral part hereof;
2. That at the time when (NAME OF CHILD) was conceived, I was not disqualified by any
legal impediment to marry her mother (NAME OF MOTHER);
3.
That on December 18, 2007 at the Saint Joseph Parish
in Barangay Ipil, Zamboanga City, Philippines, I and (NAME OF MOTHER) entered into
a valid marriage per our Certificate of Marriage with Registry No. 2007-5996
attached hereto and forming an integral part hereof; and
4.
That
this affidavit is executed to amend the Certificate of Live Birth of our child,
particularly the entry therein as to her name, from (NAME OF CHILD) to (NAME OF CHILD USING AFFIANT-FATHER'S SURNAME) pursuant to Article 179 of the Family
Code of the Philippines in relation to Article 174 thereof, and for whatever
other legal purpose this may serve.
IN
WITNESS, WHEREOF, I have hereunto set my hand this (Date) at (Place), Philippines.
(NAME OF AFFIANT-FATHER)
Affiant
SUBSCRIBED AND SWORN to before me this (Date) at (Place), Philippines by affiant who showed to me his Social
Security System ID No. ______________, a government-issued ID bearing affiant’s
photograph and signature.
WITNESS
MY HAND AND SEAL on the date and place first above written.
Doc. No. _____;
Page
No. _____;
Book
No. _____;
Series
of _____.
