REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI )S.S.)

AFFIDAVIT OF CIRCUMTANCE OF SOLO PARENT

I, MERCY T. ESCARLAN, a Filipino citizen of legal age, single, residing at Block 20 Lot 3C Pilar
Village Mines View Street Teresa Park Road 5, Las Piñas City, after being sworn to in accordance with
law, depose and say that:

1. At the age of 34, I gave birth to my son, Matthew Angelo Escarlan at Sta. Ana, Manila
on March 11, 2014;

2. That I and the biological father of my son never got married, in fact our relationship
was terminated even prior to me giving birth to my son and have never communicated ever
since the separation;

3. I was thereafter left alone with the sole responsibility of parenthood butt with the guidance
and help of my family and up to present, I am solely providing for the needs of my son;

4. I am executing this Affidavit to attest to the foregoing facts and for the purpose of securing
a Solo Parent ID and to receive the benefits under the Solo Parents’ Welfare Act of 2000.

In witness hereof, I hereby set my hands this 13th December 2018 in Makati City.

________________________

MERCY T. ESCARLAN
Affiant

SUBSCRIBED AND SWORN to before me this day __________________ affiant exhibited to her SSS No.
3356638181.

DOC. NO. _________________;

PAGE NO. _________________;
BOOK NO. _________________;
SERIES OF 2018
REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI )S.S.)

AFFIDAVIT OF LOSS

I, MERCY T. ESCARLAN, a Filipino citizen of legal age, single, residing at Block 20 Lot 3C Pilar
Village Mines View Street Teresa Park Road 5, Las Piñas City, after being sworn to in accordance with
law, depose and say that:

That I am a member of Social Security System and issued the I.D.

That the SSS I.D. was lost due to unavoidable circumstances when it was unfortunately
misplaced.

That this affidavit is executed for the purpose of informing the authorities concerned about the
loss of the ID for legal intents and purposes.

In witness hereof, I hereby set my hands this 28th January 2019 in Makati City.

________________________

MERCY T. ESCARLAN
Affiant

SUBSCRIBED AND SWORN to before me this day __________________ affiant exhibited to her SSS No.
3356638181.

DOC. NO. _________________;

PAGE NO. _________________;
BOOK NO. _________________;
SERIES OF 2019