REPUBLIC OF THE PHILIPPINES )

QUEZON CITY ) S.S.

AFFIDAVIT OF SOLO PARENT

I, Emely N. Malabarbas, a Filipino citizen of legal age, married, residing at Lot 46 Block 2 Loushef
Street Pamahay Homes Pasong Putik Proper Quezon City after being sworn to in accordance with
law, depose and say that:

1. On February 14, 2009, I was married to Uzen J. Malabarbas in a civil wedding ceremony in
Glorietta Tala Caloocan City;

2. During our relationship, we were blessed with Mayor;

3. I was left alone with the responsibility of parenthood due to ____________on___________;

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__________

Quezon City Philippines.

Emely N. Malabarbas
Affiant

SUBSCRIBED AND SWORN TO before this ________ day of ________at Quezon City, Philippines,
Attached here is my valid Voter’s Certification as my proof of identification.

Doc. No.: ______; NOTARY PUBLIC

Page No.: ______;
Book No.: ______;
Series of 2023