REPUBLIC OF THE PHILIPPINES )

) S.S.

AFFIDAVIT OF NAME AND CIVIL STATUS

AFTER MARRIAGE

KNOW ALL MEN BY THESE PRESENTS:

I, _____________________, of legal age, Filipino, married/single, and with address

at ______________________________________________________, under oath, state
that:

1. My maiden name is ___________________________;

2. I got married to Mr. __________ on ___________ at _________ as seen in the

attached Marriage Contract/Certificate, hereto referred as ANNEX “A”;

3. After marriage, my name is _____________________, and all the records have

the same name.

4. The name ____________________ (Maiden name) and _________________

(Present name) appearing in Memorandum of Encumbrances (CLOA Form No. 3), as
attached hereto as ANNEX “B”, refers to one and the same person, the herein
Affiant;

5. My present civil status is “Married”, as appearing in my personal records,

transactions and communications;

6. I am executing this Affidavit to attest to the truth of the foregoing facts and to use
the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have signed this affidavit this _____ day of

______ 2021 in the City of ________, Philippines.

____________________________
(Full Name)
Affiant

SUBSCRIBED AND SWORN to me before this __________ on ______________.

The affiant exhibited to me his/her tax identification number __________ issued at
________ on _________. (Please add details of any government issued ID).

NOTARY PUBLIC

Doc. No.
Page No.
Book No.
Series of 2021
P.S.
 Please delete/erase all words and sentences in red font.
 Please remove all the yellow highlights when already done in filling up the details.
 You may remove the underline/lines (except for the signature portion). They are there
just as guides to where to input the necessary details.
 For words with yellow highlight and slashes, please choose only one (married/single,
his/her, etc.)
 For annexes, please attach the document (example: birth certificate), to the Affidavit.
Then, please write ANNEX “A” (or whatever letter is applicable chronologically) at the
upper right portion of the annex/document.