REPUBLIC OF THE PHILIPPINES, .

]
PROVINCE OF DAVAO DEL NORTE] S. S.
CITY OF TAGUM . . . . . . . . . . . . . . . .]
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AFFIDAVIT OF ACKNOWLEDGMENT /
ADMISSION OF PATERNITY
I, RONNEL MONTEVERDE MENDOZA, legal age,
MARCELO
JR.
ASUMBRADO -LEDONJAIME R. CUTANDA, of legal age, FilipinoFilipino, single
singlesingle single and a resident of Purok Sr. San Isidro Paniquian , Banaybanay,
Davao Oriental, Philippines Prk. 4 EDEN,TORIL Tagum City Ph ilippines after having
Pob. Maco, Comval Province, Purok 5, New Leyte, Maco, Comval Province, after
having been duly sworn to in accordance with law, do hereby declare:
1 That I am the father of NEL AARON RAFAILES who was born June 4,

2003 at La Suerte Lying-in, Suaybaguio C, Magugpo North, Tagum

City whose birth was duly registered with the Office of the Local Civil
Registrar of Tagum City under Registry No. 2003-3915;
2

That at the time of the childs birth, his Certificate of Live Birth shows
that the Family Name RAFAILES was adopted from her mothers
family name since I and VERONICA ALIAR RAFAILES were not
legally married at the time our child was born;

That as a natural father of the child, NEL AARON RAFAILES, I hereby

acknowledge and declare that he is my true and legal son;

4. That I am executing this affidavit to attest to the truth of the foregoing facts
and for
whatever legal purpose this may serve well.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 5th day
of June 2014 at Tagum City, Philippines.
RONNEL MONTEVERDE
MENDOZA

Affiant

SUBSCRIBED AND SWORN to before me this 5th 9th 1ST 1st dayday of June
2014 at Tagum City, Philippines, Affiant exhibited to me his Passport bearing No.
EB1703470 issued at Tagum City, Davao del Norte, Philippines .
Doc. No. _____

Page No. _____

Book No._____
Series of 2014