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Republic of the Philippines )

Province of Samar ) S.S.


Municipality of Paranas )

Registry No:_________________

AFFIDAVIT OF LEGITIMATION
We, _______________________ and ______________________, both of legal ages, Filipinos, with
postal address at Brgy. ________________, Paranas, Samar after having been duly sworn to under oath,
hereby depose and says,

That we are the parents of the child named _______________________________ who was born on
_________________________ at Brgy. _________________, Paranas, Samar.

That the Birth Certificate of the child was registered on ___________________ in Paranas, Samar
with Registry No. ________________

That the time of the conception of the aforesaid child, we were not disqualified by any legal
impediment to marry each other but due to negligence:

That after a long time, we decided to get married on ____________________ at Paranas, Samar
with was solemnized by ______________________________

That the said Marriage Certificate was registered in the Office of the Civil Registrar of Paranas,
Samar with Registry No. __________________ on _________________________

That at the time when the child was conceived the aforesaid parents were not disqualified by any
impediment to marry each other except age, and that they subsequently enter into valid marriage, and

That by virtue of subsequent marriage, the said child is now legitimated.

Affiant sayeth naught.

IN WITNESS WHEREOF, we have hereunto set our hands this _____ day of _______________,
2020 at Paranas, Samar.

________________________________ ________________________________
Affiant Affiant

Comm. Tax No. ___________________ Comm. Tax No. ___________________


Issued on ___________________ Issued on ___________________
Issued at ___________________ Issued at ___________________

SUBSCRIBED AND SWORN TO BEFORE ME, this ________ day __________________, 2020 at
Paranas, Samar, Philippines.

ANGELITA B. DAVANTES
Municipal Civil Registrar

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