Dezarie Joie Dela Cruz SOLO PARENT

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REPUBLIC OF THE PHILIPPINES)

CITY OF MANILA )S.S.

AFFIDAVIT OF SOLO PARENT

I, LUNINGNING BAUDTO NIPA, of legal age, Filipino and postal address located 816
Oroquieta St., Sta. Cruz, Manila, having been duly sworn to in accordance with law, hereby
depose and say that:

1. I am the Mother of;

NAME

ERICKA B. NIPA
FERNANDO B. NIPA Jr.
GABRIEL B. NIPA
MICHA B. NIPA

2. I am a solo parent;

3. I am executing this affidavit to establish of the foregoing facts and for whatever legal
purpose it may deem serve.

LUNINGNING BAUDTO NIPA


Affiant

SUBSCRIBED AND SWORN to before me this _______ day of ____________, 2019 at


the City of Manila.

Doc. No. _____; NOTARY PUBLIC


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

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