REPUBLIC OF THE PHILIPPINES )

Malaybalay City, Bukidnon) S.S.

AFFIDAVIT OF CIRCUMSTANCE OF SOLO PARENT

I, KEZIA KEREN S. FLORES, Filipino, of legal age, single and a resident of

Zone 3 Purok 3, Casisang, Malaybalay City, Bukidnon, after duly sworn to in
accordance with the law, depose and state, that:
1. I am the Mother of EZEKIEL DANE FLORES, born on November 26, 2011 in
Malaybalay City, Bukidnon;

2. That I and the biological father of my son never got married, and have not
received any support from him;

3. I was thereafter left alone with the sole responsibility of parenthood but with the
guidance and help of my family and up to the present, I am solely providing for
the moral and financial support of my son;

4. Through this affidavit, I hereby declare under oath that I am the Solo Parent,
Legal Guardian and taking full custody and providing support for the above-
named Child; and

5. I am executing this Affidavit to attest to the truth and veracity of the foregoing
facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of June 2022 in
Malaybalay City, Bukidnon, Philippines.

KEZIA KEREN S. FLORES

PRC ID: 1314320

SUBSCRIBED AND SWORN, to before me this ____ of ________ at Malaybalay

City, Bukidnon, Philippines, I certify that I have personally examined the Affiant and that
I am satisfied that the said affiant has voluntarily executed and understood the content
of this Affidavit.

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REPUBLIC OF THE PHILIPPINES )
Malaybalay City, Bukidnon) S.S.

AFFIDAVIT OF CESSATION OF BUSINESS

I, SHOSHANNIM A. LOLO, Filipino, of legal age, single, and a resident of Block

11, Lot 12, Grema Village Subdivision, Casisang, Malaybalay City, Bukidnon, after duly
sworn to in accordance with the law, depose and state, that:

1. I am the registered owner of the trade name SHOSHANNIM A. LOLO with a line
of business/industry in other private education services, which business is
located at Block 11, Lot 12, Grema Village Subdivision, Casisang, Malaybalay
City, Bukidnon;

2. Sometime on May 30, 2022, I have ceased the operation of the business as the
same is not profitable due to frequent power disruption, slow internet connection,
and health issues, and can only be carried at loss;

3. I attest the truth that as of May 30, 2022, I have ceased the operation of the
aforementioned business;

4. This affidavit is not done to defraud any Government agency or institution but
was executed for the purposes of informing the agencies concerned of the
closure and cessation of the aforementioned business;

5. I am executing this Affidavit to attest to the truth and veracity of the foregoing
facts and for whatever legal purpose that this indenture may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of June 2022 in
Malaybalay City, Bukidnon, Philippines.

SHOSHANNIM A. LOLO
Affiant

SUBSCRIBED AND SWORN, to before me this ____ of ________ at Malaybalay

City, Bukidnon, Philippines, I certify that I have personally examined the Affiant and that
I am satisfied that the said affiant has voluntarily executed and understood the content
of this Affidavit.

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