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REPUBLIC OF THE PHILIPPINES )

CITY OF KABANKALAN ) s.s


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AFFIDAVIT OF LEGITIMATION

WE, SPOUSES ________________________ and ______________________,


of legal ages, Filipinos, married to each other and residents of
_________________________________________, Negros Occidental, after having
duly sworn in accordance with law hereby depose and say;

That since _________, we lived together as husband and wife without the benefit
of marriage and cohabited;

That during our cohabitation our child ______________________________ was


born on _______________________, at _____________________________________.

That on ____________________________, or after the birth of our child

_________________________________, we got married at

_____________________________________________________________________;

That although his/her name was registered as ___________________________

as such fact is shown in his/her Certificate of Live Birth, and that by reason of our

marriage was subsequently legitimated, we hereby declare and admit that

__________________________________ is our child and by virtue of our

subsequent marriage was legitimated and his/her name will be

_____________________________;

WHEREFORE, this affidavit is executed to attest the veracity of the foregoing

and to show the fact that _________________________________ through

legitimation became and have been known as

__________________________________.
IN WITNESS WHEREOF, we have hereunto affixed our signature this

_______________________________, at Kabankalan City.

_______________________ _____________________
Affiant Affiant
Gov. Issued ID: _____________ Gov. Issued ID: _________
No. _______________________ No. ___________________

SUBSCRIBED AND SWORN to before me this ___________________, at

Kabankalan City, Negros Occidental.