REPUBLIC OF THE PHILIPPINES

DONE: QUEZON CITY

AFFIDAVIT OF ONE AND THE SAME PERSON

I, XXX , of legal age, Filipino citizen, married, and a resident of XXX, after having been
sworn in accordance with law aver that;

1. I am the child of XXX;

2. I am executing this Affidavit to attest that XXX appearing in the copy of my Certificate
of Live Birth are ONE AND THE SAME PERSON; and
3. I am executing this Affidavit to attest to the truthfulness and honesty of the foregoing
facts and for all intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this ________________, 2018

in Quezon City.

__________________________

Affiant