AFFIDAVITOFCONFIRMATION-1

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Republic of the Philippines)

)
) . . .s.s.

AFFIDAVIT OF CONFIRMATION

I, CJ BARTE DE PEDRO , a Filipino of legal age,


a
resident of PUROK SILANGAN, UPPER OSMENA ST., BRGY. ZONE II,
KORONADAL CITY, SOUTH COTABATO , a bona fide member of the Philippine
National Police with the rank of PATROLMAN and presently assigned at
PRO-12 after having been duly sworn to in accordance with law, do
hereby depose and says that:

1. Pursuant to this affidavit, I am confirming that the following are my


legal beneficiaries and/or heirs, to wit:

NAME RELATIONSHIP BIRTHDATE

_____________ __________
_____________ __________
_____________ __________
___________________________ _____________ __________
___________________________ _____________ __________

2. My relationship with persons whose names are listed above are borne
out by the fact that I am the lawful legitimate/illegitimate father of the
afore-named children as evidenced by the attached birth certificate:

3. I hold myself criminally and administratively liable for perjury and dishonesty
should any statements made herein are inaccurate or later on found to
be false and in of law.

AFFIANT SAYETH NAUGHT:

_________________________
Affiant

SUBSCRIBE AND SWORN to before me this day of at


Philippines.

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