You are on page 1of 1

REPUBLIC OF THE PHILIPPINES)

City of Tacloban ) S.S.


x-----------------------x

AFFIDAVIT OF DISINTERESTED PERSON

I, ROSELYN B. AMISTOSO, Filipino citizen, of legal age, married and with residence
address at Peerless Village, Tacloban City, after having duly sworn in accordance with law,
hereby depose and state: THAT –

1. I am the Grade 4 teacher of Jhana Jhean Herlie N. Segovia who was born on September
5, 2011 in Tacloban City, Philippines;

2. That I know that her parents Jhean Hessel A. Nierras-Hatcher and Jonie B. Segovia Jr.
had already separated for quite a long time already even before Jhana Jhean became my
student at Bagacay Elementary School;

3. That I know that Jhana Jhean Herlie N. Segovia has been living with her mother and
grandparents Julito G. Nierras and Josephine A. Nierras in Peerless Village, Tacloban
City from the time she was born;

4. That I know that her father has not supported her in her schooling and, ever since I have
known Jhana, her mother has had sole responsibility;

5. That her grandparents helped her mother in raising her and in sending her to school and
paying for all her expenses;

6. That I am not related by consanguinity or affinity to the child’s parents or grandparents;

7. That I am executing this affidavit in support of the travel of said child to the United
Kingdom and for her to live there permanently and for whatever legal purpose this may
serve FURTHER AFFIANTS SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set our hands this 6th day of September
2022 in Tacloban City, Philippines.

   ROSELYN B. AMISTOSO
Affiant

 SUBCRIBED AND SWORN TO before me this 6th day of September 2022 in Tacloban


City, Philippines, affiant exhibiting to me her PRC ID with no. 0891156.

You might also like