REPUBLIC OF THE PHILIPPINES )

CITY OF BACOLOD ) S. S.

I, Steven Sbux T. Zhambomsky, Filipino, of legal age, widowed, and

with residence at Lot 45, Mars Street, Milky Way Subdivision, Barangay
Alijis, Bacolod City, Negros Occidental, after being sworn according to law,
depose and state that:
1. I am the true and legitimate Father of John TomToms R.
Zhambomsky;

2. My said son was born in Silay City, Province of Negros Occidental

Philippines, on the day of the 11th of September 2001, and is now
19 years 4 months old.

IN WITNESS WHEREOF, etc.

Steven Sbux T. Zhambomsky

Affiant

“SUBSCRIBED AND SWORN to before me this 24 th day of January,

affiant exhibiting to me his Driver’s License No. 928341 issued at Bacolod
City, Philippines on July 2018”.
WITNESS MY HAND AND NOTARIAL SEAL on the day, year and
place first above-written.

Doc. No. 20 Atty. Montvlank Castell V. Stavilo

Page No. 10 Notary Public - Bacolod City
Book No. 50 Commission Serial No. 23212321
Series of 2021 Until Dec. 31, 2024
Stavilo Law Office, Bacolod
Roll of Attorney No. 18649
PTR No. 7438232 Issued at
Bacolod City on 2005
IBP NO. 231231/2005/Bacolod