REPUBLIC OF THE PHILIPPINES)

CITY OF MANILA )SC.

AFFIDAVIT OF SINGLE PARENT

I, ___________________________, of legal age, single/married/widowed,

and a resident of _____________________________________________, after
having been duly sworn in accordance with law, hereby depose and state:

1. That I have been the occupant of the aforementioned address since

__________;
2. That I have been in continuous possession and occupation of the
house located thereat up to the present;

3. That I am a single parent to my child/children,

namely,__________________________________________________
________________________________________________________;

4. That I have assume all the financial and emotional support for my
child/children since their birth and they have likewise lived with me for
the longest time at the address above-mentioned;

5. That I am executing this affidavit to attest to the above-foregoing facts

and for whatever legal purpose it may serve.

AFFIANT SAYETH NAUGTH.

IN WITNESS WHEREOF, I have hereunto set my hand this ____day of

______________ 2008 at the City of Manila.

(Signature above Printed Name)

Affiant

Subscribed and sworn to before me, this ___ day of ___________ 2008,
after exhibiting to me her Community Tax Certificate with
No.____________________ issued on _____________________, at the City of
Manila.

Doc. No._________,
Page No. ________,
Book No. ________,
S e r i e s of 2 0 0 8.