AFFIDAVIT Consent To Use The Surname of Father HIS

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REPUBLIC OF THE PHILIPPINES }

PROVINCE OF CAVITE } S.S.


MUNICIPALITY OF TANZA }

AFFIDAVIT OF CONSENT OF THE CHILD OF LEGAL AGE


(TO USE THE SURNAME OF THE FATHER)

I, MC JAYSON M. VILLAFUERTE, Filipino citizen, of legal age, single and a


resident of Barangay Punta I, Tanza, Cavite, after being sworn in accordance with law, depose
and say that:
1. I was born on April 11, 1998 at Barangay Punta I, Tanza, Cavite;
2. I was born by virtue of the common law relationship of my parents namely
WILMA NUESTRO MONTANO and EDGARDO CARULLO VILLAFUERTE;
3. Since my parents are not legally married I am considered by law as illegitimate
child;
4. Incidental thereto, my father executed the AFFIDAVIT OF
ADMISSION/ACKNOWLEDGEMENT OF PATERNITY for me to use his last
name/surname;
5. I hereby declare under oath that I am voluntarily giving my consent and
conformity to use the surname/last name of my father;
6. I am filing this affidavit with the appropriate Local Civil Registrar Office to attest
to the truth of the foregoing facts and to cause the change of my surname.
IN WITNESS WHEREOF, I have hereunto set my hand this 12th of April, 2016 in the
Municipality of Tanza, Province of Cavite, Philippines.

MC JAYSON M. VILLAFUERTE
Affiant

DULY ATTESTED BY:

EDGARDO CARULLO VILLAFUERTE WILMA NUESTRO MONTANO


FATHER MOTHER

SUBSCRIBED AND SWORN TO before me this 12th day of April 2016 in Tanza, Cavite,
affiant exhibiting to me his Police Clearance Certificate bearing number 261431 issued on April 12, 2016
in Tanza, Cavite Philippines, with photograph and signature through which I had been able to confirm his
identity.

ATTY. SHERILYN V. PINPIN-ARCA


NOTARY PUBLIC
VALID UNTIL December 31, 2016
IBP No. 0986227; December 10, 2015; City of Imus, Cavite
PTR No. 7196906; January 4, 2016; Trece Martires City, Cavite
MCLE Compliance No. V-0011531; October 6, 2015; Manila
Roll of Attorneys No. 53995

Doc.No. _____;
Page No. _____;
Book No. XX;
Series of 2016.

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