Republic of the Philippines)

_________________...) S.S
x--------------------------/

AFFIDAVIT OF ADMISSION OF PATERNITY

I, ________________________, of legal age, single/married, Filipino

and a resident of __________________________, after having been duly
sworn to in accordance with law, do hereby depose and state that:

1. I am the biological father of the child named

____________________ who was born outside of wedlock on
_______________ at _________________________;

2. At the time of the conception of my child, I was not legally married

to his/her biological mother named ___________________;

3. I hereby admit under oath the paternity of the child

________________. He/she shall henceforth bear my surname
________________ in his/her Birth Certificate, School Records and
other legal undertakings to read as (NAME OF CHILD AND ADD SURNAME OF FATHER)
______________________________________________ and be entitled to all the
rights of an acknowledged child/legal heir pursuant to R.A. 9255;
and,

4. I am executing this Affidavit to establish the truth of the foregoing

facts and circumstances and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I do hereby set my hand this

____________ in _______________.

______________________________
Affiant

SUBSCRIBED AND SWORN to before me this _____________ in

__________________. Affiant exhibited to me competent evidence of
identity (ID No. _____________________).