You are on page 1of 1

Republic of the Philippines)

Cainta, Rizal ) SS.

AFFIDAVIT OF AUTHORIZATION
I, LEONORA A. MENDIOLA, Filipino, of legal age, widow and a resident of
Apras Anak Pawis Floodway, Barangay San Juan, Municipality of Cainta, Province of
Rizal, under oath, do hereby depose and state, that:

I am mother of LEONILA ATREGENIO MENDIOLA (“Leonila”) who was


born on June 2, 1961 in MANILA;

On October 1, 1961, Leonila was christened at Catholic Parish Church of San


Fernando de Dilao, Arch Diocese of Manila. A copy of her Certificate of Baptism is
hereto attached as Annex “A” and made an integral part hereof;

It so happened, however, when she obtained a copy of the same, it was found out
that the information about her BIRTH PLACE was registered as NO ENTRY;

I am causing the request for the partial changes in the Parish Record of Leonila,
and I hereby authorized my daughter, AURORA MENDIOLA NESUS, to transact and
negotiate with Catholic Parish Church of San Fernando de Dilao, Arch Diocese of
Manila, in my behalf;

This affidavit is being executed to attest to the veracity of the foregoing


statements for purposes not contrary to law, morals, good custom and public policy.

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of May
2019 at Cainta, Rizal.

LEONORA A. MENDIOLA
Health Identification Card No. 2013-
0499890
Issued at Makati Health Plus
Affiant

Witness to thumbmark:

AURORA MENDIOLA NESUS

SUBSCRIBED AND SWORN TO BEFORE ME on the date and at the place


above-written.
Atty. CESAR R. LOPEZ, JR.
Doc. No. 164 ; NOTARY PUBLIC
Appointment No. 18-05
Page No. 33 ; Valid until December 31, 2019
Book No. XXXVIII ; PTR No. 11262745/Jan. 4, 2019/Rizal
Lifetime IBP No. 018808/Rizal
Series of 2019. Roll No. 42306
MCLE Compliance No. V-0018136
April 12, 2016

You might also like