Republic of the Philippines }

Butuan City } S.S.

X===================X

AFFIDAVIT OF ADMISSION OF PATERNITY

I, ____________________________________, of legal age, and presently residing at

________________________________________________, after having been duly sworn to
in accordance with law do hereby depose and say:

1. That I am the biological father of the child, _____________________________,

who was born on ________________ at
_______________________________________________________.

2. That at the time of birth of said child, I am not married to his/her mother,
____________________________________.

3. That I hereby acknowledge my paternity/filiation to the child

________________________________.
4. That I am executing this affidavit to attest the truth of the foregoing facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th day of

February at Butuan City, Agusan Del Norte.

________________________________
(Signature over printed name of Affiant)

SUBSCRIBED AND SWORN to before me this 14th day of February 2019 in the City
of Butuan, affiant exhibiting his _________________. I certify that I personally examined the
affiant and that he voluntarily executed the foregoing affidavit and understood the contents
thereof.