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    Affidavit of Acknowledgment Blank

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    alexredrose
    This affidavit acknowledges the paternity and consents to use of the father's surname of a child. It states that the affiant is the biological father of the child named, who was born on a specific date in a hospital. It acknowledges paternity and filiation of the child. The affiant gives consent for the child to use his surname and for this to be reflected in the birth certificate. The affidavit is being executed to attest to these facts and support the child's claim with relevant registration authorities.

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    © All Rights Reserved
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    Affidavit of Acknowledgment Blank

    Uploaded by

    alexredrose
    2K views1 page
    This affidavit acknowledges the paternity and consents to use of the father's surname of a child. It states that the affiant is the biological father of the child named, who was born on a specific date in a hospital. It acknowledges paternity and filiation of the child. The affiant gives consent for the child to use his surname and for this to be reflected in the birth certificate. The affidavit is being executed to attest to these facts and support the child's claim with relevant registration authorities.

    Original Description:

    AFFIDAVIT OF ACKNOWLEDGMENT OF PATERNITY AND CONSENT TO USE THE SURNAME OF FATHER

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    © © All Rights Reserved

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    This affidavit acknowledges the paternity and consents to use of the father's surname of a child. It states that the affiant is the biological father of the child named, who was born on a specific date in a hospital. It acknowledges paternity and filiation of the child. The affiant gives consent for the child to use his surname and for this to be reflected in the birth certificate. The affidavit is being executed to attest to these facts and support the child's claim with relevant registration authorities.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    2K views1 page

    Affidavit of Acknowledgment Blank

    Uploaded by

    alexredrose
    This affidavit acknowledges the paternity and consents to use of the father's surname of a child. It states that the affiant is the biological father of the child named, who was born on a specific date in a hospital. It acknowledges paternity and filiation of the child. The affiant gives consent for the child to use his surname and for this to be reflected in the birth certificate. The affidavit is being executed to attest to these facts and support the child's claim with relevant registration authorities.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    REPUBLIC OF THE PHILIPPINES )

    PROVINCE OF NEGROS ORIENTAL) S.S.


    CITY OF DUMAGUETE......................)

    AFFIDAVIT OF ACKNOWLEDGMENT OF PATERNITY AND


    CONSENT TO USE THE SURNAME OF FATHER

    I, __________________, of legal age, Filipino, and a resident of


    Lopez, Quezon Province, Philippines, after having been duly sworn to in
    accordance with law, do hereby depose and state:

    1. That I am the biological father of _______________ who was born


    on ________________ in Philippine General Hospital, Metro Manila,
    Philippines;

    2. That at the time of the birth of ____________________, I was not


    legally married to his biological mother _________________;

    3. That I hereby acknowledge my paternity/filiation of


    ________________;

    4. That I am giving my consent for ______________ to use my


    surname and that the same be reflected in his birth certificate;

    5. That I am executing this Affidavit to attest to the truth of the


    foregoing statement of fact and to support the claim of my son ARVY
    RODULFO with the Local Civil Registrar (LCR), National Statistics Office
    (NSO) or Philippine Statistics Authority (PSA) and for whatever it may serve
    him best.

    IN WITNESS WHEREOF, I have hereunto set my hand this


    _____________ in ________________, Philippines.

    Affiant
    ID NO. _______________________

    JURAT

    SUBSCRIBED AND SWORN to before me this _____________ in


    ________________, Philippines.

    Doc No.: ___


    Page No.: ___
    Book No.: ___
    Series of 2017.

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