Republic of the Philippines )

Province of Bohol )s.s.

Municipality of Ubay )

AFFIDAVIT OF SOLO PARENT

I, TTTTT, Filipino, of legal age, single, and resident of A, Ubay, Bohol,

after having been duly sworn to in accordance with law, do hereby depose and
state:

1. I am the mother of the child, BBBBB, born on January xx, xxxx;

2. That his biological father is CCCCCC;

3. That his biological father abandoned us since I gave birth to my child. He

abandoned us without providing any financial support to our child and I was
left solo or alone with the responsibility of taking good care and providing
support for our child

4. Through this Affidavit, I hereby declare under oath that I am a solo parent
and the one taking custody and providing for the support of the above-
mentioned children;

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

IN WITNESS WHEREOF, I have hereunto set my hand this 28 th day of

February 2023, at Ubay, Bohol.

TTTTT
Affiant

SUBSCRIBED AND SWORN to before me this 28th day of February 2023

at Ubay, Bohol.

WITNESS MY HAND AND SEAL.