AFFIDAVIT OF ADMISSION OF PATERNITY

I, ___________________, of legal age, married, a U.S. citizen and presently residing at

_________________________________, after having been duly sworn to in accordance with
law do hereby depose and say:

1. That I am the biological father of the child, _________________, who was born on
________________ at the ________________________________________;

2. That while in his Birth Certificate, I was not named as his father as the information about
______’s father was left blank by the informant, his mother, _____________, I
acknowledge, confirm and affirm that _____________________ is my biological son
borne out of my out-of-wedlock relationship with _______________________;

3. That at the time of _________’s birth, I was not legally married to his mother,
___________________________ nor did we subsequently marry;

4. That by this instrument I acknowledge, confirm and affirm that ______________ is my

biological son.

5. I am executing this Affidavit for the purpose of attesting to the truth of the facts above-
stated and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______ day of

____________________ at _______________________________________________.

____________________________
Print Name and Signature (father)
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of ___________________

20____ at the Philippine Consulate General, San Francisco, U.S.A.

____________________________
Notary Public