Republic of the Philippines )

City of Catbalogan ) s.s.

AFFIDAVIT OF GUARDIANSHIP
I, EMELYN B. ESPINO, of legal age, married, and resident of
Brgy.Yangta,Daram, Samar, Philippines, after having been sworn to in
accordance with law, do hereby depose and state that:

1. That I am the grandmother of the minor, KEESHA ANGEL ESPINO RONQUILLO,

who was born on Jan. 11, 2014 to KAREN JOY ESPINO and ROD ANGEL RONQUILLO
at Imus, Cavite;

2. That the mother of the above mentioned minor is my daughter;

3. That since birth until present, the parents of KEESHA ANGEL ESPINO
RONQUILLO left the care and custody of their daughter to me;

4. I hereby declare myself as the guardian of my grandaughter, Keesha Angel

Espino Ronquillo; and

5. That I am executing this Affidavit of Guardianship in support of the

application of PSA Certificate of Livebirth and to declare the truth of
the foregoing facts and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto set my hand this 13th day of March 2019
at Catbalogan,City, Samar, Philippines.

EMELYN B. ESPINO
Affiant

SUBSCRIBED AND SWORN to before me this 13th day of March at Catbalogan,

City, Samar, Philippines. Affiant exhibiting to me her 4P’s ID NO. 086006059-
1269-00006, bearing his photograph and signature.

Doc. No. _________;

Page No. _________;
Book No. _________;
Series of 2019