REPUBLIC OF THE PHILIPPINES )

Province of Nueva Ecija ) S.S.

Science City of Munoz )

AFFIDAVIT OF GUARDIANSHIP
I, SHIRLEY MALYNE G. MCCALL, of legal age, Filipino, married, and presently
residing at Purok 5, Barangay Baloc, Sto. Domingo, Nueva Ecija, after having been sworn to in
accordance with law, hereby depose and state, THAT:

1. Sometime on 2009, DARYLL M. GUTIERREZ the mother of JANELLE

ANDREA M. GUTIERREZ who was born on June 20, 2009 at Baloc, Sto,
Domingo, Nueva Ecija, left the care and custody of her daughter to me;

2. For more than ten (10) years, I have been the guardian of JANELLE ANDREA
M. GUTIERREZ and she is under my care and custody;

3. My husband and I filed a Petition for Adoption of JANELLE ANDREA M.

GUTIERREZ and is pending before the Regional Trial Court Branch 88 of
Baloc, Sto. Domingo, Nueva Ecija;

4. I am not an imbecile, insane, a vagrant or a vicious person or a habitual drunkard

or a habitual criminal, and have not abandoned, neglected or refused to support
said minor or caused him to commit offenses against the law.

5. I have executed this affidavit to attest to the truthfulness of the foregoing facts,
and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this October 7, 2019 at

Science City of Munoz, Nueva Ecija.

___________________________
SHIRLEY MALYNE G. MCCALL
Affiant
Driv Lic No.: C05-08-002130
Issued by: Land and Transportation

SUBSBRIBED and SWORN to before me this October 7, 2019 at Science City of Munoz,
Nueva Ecija and I hereby certify that the affiant has read the contents of his affidavit and
understands the same.

Doc No._________;
Page No._________;
Book No.________;
Series of 2019.