AFFIDAVIT OF TWO DISINTERESTED PERSONS FOR A SOLO PARENT

We, ARMIE LHEA NUCASA ABAN and JOMAR LOZANO ABAN, both of legal ages, Filipinos, and
residents of Baguio City, after having been duly sworn to in accordance with law, hereby depose and
state:

1. That we have been residents of Baguio City for more than __ years, and during this period of
time, we have personally known __Zel___________, being our neighbour and close
acquaintance;

2. That during the same period of time we personally know __anak__________ as the child of
____Zel;

3. That during the lifetime of the said family in the neighbourhood, we have continuously
observed and known that ex-partners __Zel___________________ and
________ex____________ had no other children, legitimate or otherwise, deceased or
surviving, living with them or in some place other than the family home or abode; and

4. That her ex partner had abandoned her and her child while she was still three (3) months
pregnant with their child;

5. That Zel is qualified for the benefits provided under the Solo Parents Welfare Act of 2000 as
defined under Section 3(a) of the Solo Parents Welfare Act of 2000 as she is a parent left solo
or alone with the responsibility of parenthood due to the abandonement of her child’s father
for more than sixteen (16) years now;

6. That we are executing this joint affidavit to attest to the truth and veracity of the foregoing set
of facts without any promise or reward or any other monetary consideration but solely for the
purpose of declaring the above mentioned facts and for other legal intents.

FURTHER AFFIANTS SAYETH NONE.

IN WITNESS WHEREOF, we have hereunto affixed our respective signatures this

_______________ day of _________________, ___________ at _______________.

ARMIE LHEA NUCASA ABAN JOMAR LOZANO ABAN

Affiant Affiant
Government issued ID No. ______ Government issued ID No. ______
Issued on ___________________ Issued on ___________________
Issued at ___________________ Issued at ___________________

SUBSCRIBED AND SWORN to before me this _______ day of _________, ________ at the City
of ______________, Philippines, the affiants exhibiting to me their Government issued IDs written
below their respective names.

Doc. No. ________

Page No. ________
Book No. ________
Series of ________ NOTARY PUBLIC