Republic of the Philippines)

CITY OF ZAMBOANGA. . . . . ) S.S.

x- - - - - - - - - - - - - x

AFFIDAVIT
(ONE AND THE SAME PERSON)

I, ___________, of legal age, Filipino, married to_________,

and with address_______________________, Zamboanga City, after
having been sworn in accordance with law, hereby depose and say:

That I am the biological father of___________, a female

child who was born on(Date of birth), in Quezon City,
Philippines, and whose mother is ____________, as shown by his
Certificate of Live Birth hereto attached as Annex “A”;

That at the time our said daughter was born, I and her
mother were not yet married although we did not have any
impediment to marry each;

That subsequent to the birth of our said daughter, we

formalized our marital union by a marriage celebrated on (Date of
wedding), in (Place where the marriage was held), before the
Philippine Consul thereat, as shown by our CERTIFICATE OF
MARRIAGE, a copy of which is hereto attached as Annex “B”;

That by virtue of our said subsequent marriage, our said

daughter was legitimated but we have not yet been able to cause
the aforesaid fact to be registered in the proper registry;

That when our said daughter was enrolled as an elementary

student at the Western Mindanao State University Integrated
Laboratory School, (WMSU-ILS) she used the name________________;

That the names ________ and ________ all refer to our said
daughter as one and the same person;

That we are executing this affidavit to attest to the truth

of the foregoing narration of facts in connection with our
request with the WMSU – ILS for the correction and change of the
name in the school record of our said daughter from NORGELYN D.
EBOL to NORGELYN DOGILLO to conform with his Certificate of Live
Birth and for all the legal purposes that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this

(Date,Month,Year)in the City of Zamboanga, Philippines.

_________
Affiant

SUBSCRIBED AND SWORN to before me by the Affiants who are

all personally known to me on this (Date,Month,Year)in the City
of Zamboanga, Philippines.

Doc. No. ____; Page No. ____;

Book No. ____; Series of 2014