REPUBLIC OF THE PHILIPPINES )

CAVITE ) S.S.

AFFIDAVIT OF CIRCUMSTANCE OF SOLO

PARENT

I, Jovelyn G. Lindong, a Filipino citizen of legal age, single, residing at

#184 Sitio Cubao, Kabulusan, General Emilio Aguinaldo, Cavite, after being sworn
to in accordance with law, hereby depose and say that:

1. That I was not married up to present and I am the biological mother of

my daughter;

2. That at the age of twenty-three (23), I gave birth to my daughter Ven

Angelie Lindong on January 15, 1985 in Kabulusan, General Emilio Aguinaldo,
Cavite.

3. That since then I was afterward left alone with the sole responsibility of
parenthood but with the guidance and help of my family and in fact up to this date, I
am solely providing for their needs;

4. I am executing this Affidavit to attest to the foregoing facts and for the
purpose of securing a Solo Parent ID and to receive the benefits under the Solo
Parents’ Welfare Act of 2000.

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

______________ in _______________________, Philippines

Jovelyn G. Lindong
Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of

___________in __________________________, Philippines, affiant exhibiting to me
her ___________________evidence of identity indicated below her printed name,
bearing her picture and signature appearing therein.

Notary Public

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Series of 2023