Republic of the Philippines )

Quezon City ) S.S.

AFFIDAVIT

I, REMEDIOS D. BONITA – BOLAÑOS of legal age Filipino, married to Vidal D. Nolanos,

and with residence address at #30 BF Road Brgy. Holy Spirit, Quezon City, after having sworn to
in accordance with law do hereby deposes and state:

1. That I am the biological mother of APRIL SHARRON BONITA BOLAÑOS;

2. That she was born on April 14, 1987 at Sorsogon Provincial Hospital, Macabog,
Sorsogon, Sorsogon;

3. That I was the informant of the data/entries on her birth certificate of live birth entered
under Local Civil Registry No. 87-935 of the Local Civil Registry of Sorsogon on July 3,
1987;

4. That when I found out that the name entered was APRIL BONITA BOLAÑOS, I exerted
effort to supply the information for the supplemental report which should read as APRIL
SHARRON BONITA BOLAÑOS;

5. That only as of this date, when I saw the NSO copy of her certificate of live birth, I found
out that that my supplemental report was never realized and that the name entered
was still ARPIL BONITA BOLAÑOS;

6. That I am executing to support whatever legal purpose this may serve with regard to the
Certificate of Live birth of my daughter and to state that APRIL BONITA BOLAÑOS and
APRIL SHARRON BONITA BOLAÑOS.

IN WITNESS WHEREOF, I have hereunto set my hand this 14 TH day of June, 2021 in
Quezon City.

REMEDIOS D. BONITA – BOLAÑOS

Affiant
ID No. ______________

SUBSCRIBED AND SWORN TO before me this 14 TH day of June, 2021 in Quezon City.
Affiant exhibited to me his/her Identification documents as proof of his/her identity.

Doc. No._____
Page No._____
Book No._____
Series of 2021.