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"AFFIDAVIT OF ACKNOWLEDGMENTIADMISSION OF #ATERNITY
vin, te ME SEHR”
of legal age, arwvare the ratural moiner andlor fiher ot Inncinith Tumisant. “Da Teon _yillagfeacho was
ea aay
grein tis atid alata he rhkshose ofthe regolng ststemants ap opposes of
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suBscriseD AND SWORN io betre mes cayt_- WAR OG 1A yy
ed — aio ORE ar
crema ee Ty e iesved on FebRyey 18. 2020 a
oC No,
BOOK NO,
FOR DELAYED REGIST
(eben ye he cia hn mapa ep Be pe eo
oftegal ae, siolelmarrdtdworceatvidomwicower, wih
tesidence and postal accross ae
‘ter having been duly swom i ecsordance with aw, do hereby depose and s9y
1. Tt | ar the apptcant forthe delayed registaon of
Coy tit in on
Tine bit of ‘who was born In
2. That thelshe was atenéed st bith by ho esos a
‘3. That | amielabe Isa tizen of
4. That myfiamorpovonts ware) married on at
oot marie but iets nas acknowedgesinat acknowledged by
. hie father whose nama
5. Thal the season forthe delay le roystring mpi ith was
(Fort eppfcant ony) That | mata to
(ihe applicant i tte than the document owner) That | am the ofthe ais person,
7. That am exaouting thi aida 1.8
‘nents and purposes:
fo tha tantuness of he foregoing statements fra
In tnth whereof, | havo attvod my signature below tis day of
at Pappas
eos ce tae
SUBSCRIBED AND SWORN to belore me ths day of
Priigaloes, aan who
rae si rss ms ——
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