REPUBLIC OF THE PHILIPPINES)

PROVINCE OF _________________) S.S.

CITY/MUNICIPALITY OF _________________)
x- - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF GUARDIANSHIP

            I, ______________________, of legal age, married, Filipino

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

1.  That I am the sister and legal custodian of the minor

______________________, who was born on ______________________and
is now fifteen (15) years of age;

2.  That the said child is currently living with me in my above-

stated residence and is under my care, support, and custody; 

3.  That I am fully capacitated to take care of the minor child, I

am not an imbecile, insane, a vagrant, a vicious person,
a habitual drunkard or a habitual criminal, and have not
abandoned, neglected or refused to support the said person or
caused her to commit offenses against the law; and

4.  That I am executing this affidavit to obtain a copy of my

said sister’s Certificate of Live Birth from the Philippine Statistics
Authority and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

______________________in ______________________.

______________________
Affiant
                     ID No. ______________________

SUBSCRIBED AND SWORN TO BEFORE ME this

______________________ in ______________________.