REPUBLIC OF THE PHILIPPINES )

Province of Ilocos Norte )

City of Batac ) S.S

AFFIDAVIT

I, EDWIN MEJIA y Bagcal, of legal age, Filipino and a resident of Paoay, Ilocos
Norte, after having been duly sworn to in accordance with law do hereby depose and state
that:

1. I am the biological father of MARWIN MEJIA y Molina as stated and registered

in her Certificate of Live Birth issued by the Philippine Statistics Office. A copy
of her Certificate of Live Birth is hereto attached and marked as “Annex A”;
2. That my daughter is currently enrolled at Wilbur C. Go National High School in
Currimao, Ilocos Norte and is about to graduate from high school this school year
2020-2021;
3. Per her school records, her name is recorded as MARWIN MOLINA y Mejia
when it should be MARWIN MEJIA y Molina considering that she should follow
the surname of his biological father which is MEJIA;
4. That in order to correct and straighten her school records and other public and
official records, I am executing this affidavit to correct the entries in the school
records of my daughter MARWIN MEJIA as follows:

SURNAME – MEJIA
MIDDLE NAME – MOLINA

5. I am executing to attest to the foregoing facts and to use the same for whatever
legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of

December 2020 at Batac City, Ilocos Norte, Philippines.

EDWIN BAGCAL MEJIA

Affiant

SUBSCRIBED AND SWORN to before me this 17th day of December 2020 at

Batac City, Ilocos Norte, Philippines.