Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 1: Birth of a Child in consequence
of rape
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2.Complaint Affidavit; (1 Photocopy)
_______3. Medical Record on the incident of
rape (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are
under the parental care and support of the
solo parent applicant. (1 original)
REMARKS:
___________________________________________
___________________________________________
___________________________________________
_______________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 1: Birth of a Child in consequence
of rape
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2.Complaint Affidavit; (1 Photocopy)
_______3. Medical Record on the incident of
rape (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are
under the parental care and support of the
solo parent applicant. (1 original)
REMARKS:
___________________________________________
___________________________________________
___________________________________________
_______________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 1: Birth of a Child in consequence
of rape
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2.Complaint Affidavit; (1 Photocopy)
_______3. Medical Record on the incident of
rape (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are
under the parental care and support of the
solo parent applicant. (1 original)
REMARKS:
___________________________________________
___________________________________________
___________________________________________
_______________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 1: Birth of a Child in consequence
of rape
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2.Complaint Affidavit; (1 Photocopy)
_______3. Medical Record on the incident of
rape (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are
under the parental care and support of the
solo parent applicant. (1 original)
REMARKS:
___________________________________________
___________________________________________
___________________________________________
_______________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 1: Birth of a Child in consequence
of rape
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2.Complaint Affidavit; (1 Photocopy)
_______3. Medical Record on the incident of
rape (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are
under the parental care and support of the
solo parent applicant. (1 original)
REMARKS:
___________________________________________
___________________________________________
___________________________________________
_______________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 1: Birth of a Child in consequence
of rape
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2.Complaint Affidavit; (1 Photocopy)
_______3. Medical Record on the incident of
rape (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are
under the parental care and support of the
solo parent applicant. (1 original)
REMARKS:
___________________________________________
___________________________________________
___________________________________________
_______________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 3: Spouse of Person Deprived of
Liberty (PDL) Nakakulong
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Certificate of detention or a
certification that the spouse is serving
sentences for at least 3 months issued by the
law enforcement agency or commitment order
issued by the court; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
______
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 3: Spouse of Person Deprived of
Liberty (PDL) Nakakulong
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Certificate of detention or a
certification that the spouse is serving
sentences for at least 3 months issued by the
law enforcement agency or commitment order
issued by the court; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
______
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 3: Spouse of Person Deprived of
Liberty (PDL) Nakakulong
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Certificate of detention or a
certification that the spouse is serving
sentences for at least 3 months issued by the
law enforcement agency or commitment
order issued by the court; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
______
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 3: Spouse of Person Deprived of
Liberty (PDL) Nakakulong
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Certificate of detention or a
certification that the spouse is serving
sentences for at least 3 months issued by the
law enforcement agency or commitment
order issued by the court; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
______
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 3: Spouse of Person Deprived of
Liberty (PDL) Nakakulong
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Certificate of detention or a
certification that the spouse is serving
sentences for at least 3 months issued by the
law enforcement agency or commitment
order issued by the court; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
______
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 3: Spouse of Person Deprived of
Liberty (PDL) Nakakulong
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Certificate of detention or a
certification that the spouse is serving
sentences for at least 3 months issued by the
law enforcement agency or commitment
order issued by the court; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
______
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 4: Spouse of Person with Disability
(PWD)
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Medical Record or medical abstract
evidencing the physical or mental state of the
incapacitated spouse issued not more than 3
months before submission; (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
_____________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 4: Spouse of Person with Disability
(PWD)
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Medical Record or medical abstract
evidencing the physical or mental state of the
incapacitated spouse issued not more than 3
months before submission; (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
_____________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 4: Spouse of Person with Disability
(PWD)
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Medical Record or medical abstract
evidencing the physical or mental state of the
incapacitated spouse issued not more than 3
months before submission; (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
_____________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 4: Spouse of Person with Disability
(PWD)
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Medical Record or medical abstract
evidencing the physical or mental state of the
incapacitated spouse issued not more than 3
months before submission; (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
_____________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 4: Spouse of Person with Disability
(PWD)
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Medical Record or medical abstract
evidencing the physical or mental state of the
incapacitated spouse issued not more than 3
months before submission; (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
_____________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 4: Spouse of Person with Disability
(PWD)
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Medical Record or medical abstract
evidencing the physical or mental state of the
incapacitated spouse issued not more than 3
months before submission; (1 Photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
_____________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 7: Abandoned
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy)or affidavit of the
applicant solo parent; (1 Photocopy)
_______3. Affidavit of 2 disinterested persons
attesting to the abandonment of the spouse;
(1 Photocopy)
_______4. Police or Barangay record of the fact
of abandonment (1 photocopy)
_______5. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______6. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 7: Abandoned
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy)or affidavit of the
applicant solo parent; (1 Photocopy)
_______3. Affidavit of 2 disinterested persons
attesting to the abandonment of the spouse;
(1 Photocopy)
_______4. Police or Barangay record of the fact
of abandonment (1 photocopy)
_______5. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______6. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 7: Abandoned
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy)or affidavit of the
applicant solo parent; (1 Photocopy)
_______3. Affidavit of 2 disinterested persons
attesting to the abandonment of the spouse;
(1 Photocopy)
_______4. Police or Barangay record of the fact
of abandonment (1 photocopy)
_______5. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______6. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 7: Abandoned
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy)or affidavit of the
applicant solo parent; (1 Photocopy)
_______3. Affidavit of 2 disinterested persons
attesting to the abandonment of the spouse;
(1 Photocopy)
_______4. Police or Barangay record of the fact
of abandonment (1 photocopy)
_______5. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______6. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 7: Abandoned
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy)or affidavit of the applicant
solo parent; (1 Photocopy)
_______3. Affidavit of 2 disinterested persons
attesting to the abandonment of the spouse; (1
Photocopy)
_______4. Police or Barangay record of the fact
of abandonment (1 photocopy)
_______5. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______6. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
______________________________________________
______________________________________________
______________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 7: Abandoned
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy)or affidavit of the applicant
solo parent; (1 Photocopy)
_______3. Affidavit of 2 disinterested persons
attesting to the abandonment of the spouse; (1
Photocopy)
_______4. Police or Barangay record of the fact
of abandonment (1 photocopy)
_______5. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______6. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
______________________________________________
______________________________________________
______________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 8: Spouse of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s spouse
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 8: Spouse of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s spouse
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 8: Spouse of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s spouse
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 8: Spouse of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s spouse
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 8: Spouse of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s spouse
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 8: Spouse of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Marriage Certificate (PSA or CCR
Certified true Copy); (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s spouse
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 9: Relative of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Birth Certificate or other competent
proof of the relationship between the
applicant and the OFW, (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s relative
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 9: Relative of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Birth Certificate or other competent
proof of the relationship between the
applicant and the OFW, (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s relative
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 9: Relative of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Birth Certificate or other competent
proof of the relationship between the
applicant and the OFW, (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s relative
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 9: Relative of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Birth Certificate or other competent
proof of the relationship between the
applicant and the OFW, (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s relative
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 9: Relative of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Birth Certificate or other competent
proof of the relationship between the
applicant and the OFW, (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s relative
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
_____CATEGORY 9: Relative of OFW
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Birth Certificate or other competent
proof of the relationship between the
applicant and the OFW, (1 Photocopy)
_______3. Philippine Overseas Employment
Administration Standard Employment
Contract (POEA-SEC) or its equivalent
document; (1 Photocopy)
_______4. Photocopy of OFW passport with the
stamp showing continuous twelve (12) months
of overseas work, or a certification from the
Bureau of Immigration
_______5. Proof of income of the OFW’s relative
(1 photocopy)
_______6. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______7. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 11: legal Guardian, the adoptive or
foster parent who solely provides parental care
and support to a child or children
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Proof of guardianship, such as the
decision granting legal guardianship issued by
a court; proof of adoption such as a decree of
adoption issued by the court, or order of
adoption issued by DSWD or NACC, proof of
foster care such as a Foster Parent License
issued by DSWD or the NACC; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 11: legal Guardian, the adoptive or
foster parent who solely provides parental care
and support to a child or children
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Proof of guardianship, such as the
decision granting legal guardianship issued by
a court; proof of adoption such as a decree of
adoption issued by the court, or order of
adoption issued by DSWD or NACC, proof of
foster care such as a Foster Parent License
issued by DSWD or the NACC; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 11: legal Guardian, the adoptive or
foster parent who solely provides parental care
and support to a child or children
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Proof of guardianship, such as the
decision granting legal guardianship issued by
a court; proof of adoption such as a decree of
adoption issued by the court, or order of
adoption issued by DSWD or NACC, proof of
foster care such as a Foster Parent License
issued by DSWD or the NACC; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 11: legal Guardian, the adoptive or
foster parent who solely provides parental care
and support to a child or children
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Proof of guardianship, such as the
decision granting legal guardianship issued by
a court; proof of adoption such as a decree of
adoption issued by the court, or order of
adoption issued by DSWD or NACC, proof of
foster care such as a Foster Parent License
issued by DSWD or the NACC; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 11: legal Guardian, the adoptive or
foster parent who solely provides parental care
and support to a child or children
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Proof of guardianship, such as the
decision granting legal guardianship issued by
a court; proof of adoption such as a decree of
adoption issued by the court, or order of
adoption issued by DSWD or NACC, proof of
foster care such as a Foster Parent License
issued by DSWD or the NACC; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 11: legal Guardian, the adoptive or
foster parent who solely provides parental care
and support to a child or children
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Proof of guardianship, such as the
decision granting legal guardianship issued by
a court; proof of adoption such as a decree of
adoption issued by the court, or order of
adoption issued by DSWD or NACC, proof of
foster care such as a Foster Parent License
issued by DSWD or the NACC; (1 Photocopy)
_______4. Sworn Affidavit declaring that the solo
parent has the sole parental care and support
of the child or children at the time of the
execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_____________________________________________
_____________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 12: Any relative within the fourth
(4th) civil degree of consanguinity or affinity
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Death Certificate, certificate of
incapacity, or judicial declaration of absence
or presumptive death of the parents or legal
guardian; police or barangay records
evidencing the fact of disappearance or
absence of the parent or legal guardian for at
least six months; (1 Photocopy)
_______3. Proof of relationship of the relative to
the parent or legal guardian, such as birth
certificate, marriage certificate, family
records, or other similar or analogous proof of
relationship. (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
__________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 12: Any relative within the fourth
(4th) civil degree of consanguinity or affinity
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Death Certificate, certificate of
incapacity, or judicial declaration of absence
or presumptive death of the parents or legal
guardian; police or barangay records
evidencing the fact of disappearance or
absence of the parent or legal guardian for at
least six months; (1 Photocopy)
_______3. Proof of relationship of the relative to
the parent or legal guardian, such as birth
certificate, marriage certificate, family
records, or other similar or analogous proof of
relationship. (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
__________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 12: Any relative within the fourth
(4th) civil degree of consanguinity or affinity
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Death Certificate, certificate of
incapacity, or judicial declaration of absence
or presumptive death of the parents or legal
guardian; police or barangay records
evidencing the fact of disappearance or
absence of the parent or legal guardian for at
least six months; (1 Photocopy)
_______3. Proof of relationship of the relative to
the parent or legal guardian, such as birth
certificate, marriage certificate, family records,
or other similar or analogous proof of
relationship. (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 12: Any relative within the fourth
(4th) civil degree of consanguinity or affinity
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Death Certificate, certificate of
incapacity, or judicial declaration of absence
or presumptive death of the parents or legal
guardian; police or barangay records
evidencing the fact of disappearance or
absence of the parent or legal guardian for at
least six months; (1 Photocopy)
_______3. Proof of relationship of the relative to
the parent or legal guardian, such as birth
certificate, marriage certificate, family records,
or other similar or analogous proof of
relationship. (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 12: Any relative within the fourth
(4th) civil degree of consanguinity or affinity
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Death Certificate, certificate of
incapacity, or judicial declaration of absence
or presumptive death of the parents or legal
guardian; police or barangay records
evidencing the fact of disappearance or
absence of the parent or legal guardian for at
least six months; (1 Photocopy)
_______3. Proof of relationship of the relative to
the parent or legal guardian, such as birth
certificate, marriage certificate, family
records, or other similar or analogous proof of
relationship. (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 12: Any relative within the fourth
(4th) civil degree of consanguinity or affinity
Requirements:
_______1. Birth certificate/s of the child or
children; (PSA or CCR Certified true Copy) 1
photocopy
_______2. Death Certificate, certificate of
incapacity, or judicial declaration of absence
or presumptive death of the parents or legal
guardian; police or barangay records
evidencing the fact of disappearance or
absence of the parent or legal guardian for at
least six months; (1 Photocopy)
_______3. Proof of relationship of the relative to
the parent or legal guardian, such as birth
certificate, marriage certificate, family
records, or other similar or analogous proof of
relationship. (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of the
barangay and that the children are under the
parental care and support of the solo parent
applicant. (1 original)
REMARKS:
_____________________________________________
_________________________________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 13: A pregnant woman who
provides sole parental care and support to
unborn child or children
4
Requirements:
_______1. Medical Record of her pregnancy (1
photocopy)
_______2.Sworn Affidavit declaring that the
solo parent is not cohabiting with a partner or
co-parent who is providing support to the
pregnant woman (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 13: A pregnant woman who
provides sole parental care and support to
unborn child or children
Requirements:
_______1. Medical Record of her pregnancy (1
photocopy)
_______2.Sworn Affidavit declaring that the
solo parent is not cohabiting with a partner or
co-parent who is providing support to the
pregnant woman (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 13: A pregnant woman who
provides sole parental care and support to
unborn child or children
Requirements:
_______1. Medical Record of her pregnancy (1
photocopy)
_______2.Sworn Affidavit declaring that the
solo parent is not cohabiting with a partner or
co-parent who is providing support to the
pregnant woman (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 13: A pregnant woman who
provides sole parental care and support to
unborn child or children
Requirements:
_______1. Medical Record of her pregnancy (1
photocopy)
_______2.Sworn Affidavit declaring that the
solo parent is not cohabiting with a partner or
co-parent who is providing support to the
pregnant woman (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 13: A pregnant woman who
provides sole parental care and support to
unborn child or children
Requirements:
_______1. Medical Record of her pregnancy (1
photocopy)
_______2.Sworn Affidavit declaring that the
solo parent is not cohabiting with a partner or
co-parent who is providing support to the
pregnant woman (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 13: A pregnant woman who
provides sole parental care and support to
unborn child or children
Requirements:
_______1. Medical Record of her pregnancy (1
photocopy)
_______2.Sworn Affidavit declaring that the
solo parent is not cohabiting with a partner or
co-parent who is providing support to the
pregnant woman (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
 Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 6: Nullity/Annulment of Marriage
Requirements:
_______1. Birth Certificate of the Child or
children (1 photocopy)
_______2. Marriage Certificate (PSA or CCR
Certified True Copy); (1 photocopy)
_______3. Judicial decree of nullity or
annulment of marriage or judicial recognition
of foreign divorce; (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 6: Nullity/Annulment of Marriage
Requirements:
_______1. Birth Certificate of the Child or
children (1 photocopy)
_______2. Marriage Certificate (PSA or CCR
Certified True Copy); (1 photocopy)
_______3. Judicial decree of nullity or
annulment of marriage or judicial recognition
of foreign divorce; (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 6: Nullity/Annulment of Marriage
Requirements:
_______1. Birth Certificate of the Child or
children (1 photocopy)
_______2. Marriage Certificate (PSA or CCR
Certified True Copy); (1 photocopy)
_______3. Judicial decree of nullity or
annulment of marriage or judicial recognition
of foreign divorce; (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 6: Nullity/Annulment of Marriage
Requirements:
_______1. Birth Certificate of the Child or
children (1 photocopy)
_______2. Marriage Certificate (PSA or CCR
Certified True Copy); (1 photocopy)
_______3. Judicial decree of nullity or
annulment of marriage or judicial recognition
of foreign divorce; (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 6: Nullity/Annulment of Marriage
Requirements:
_______1. Birth Certificate of the Child or
children (1 photocopy)
_______2. Marriage Certificate (PSA or CCR
Certified True Copy); (1 photocopy)
_______3. Judicial decree of nullity or
annulment of marriage or judicial recognition
of foreign divorce; (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer
Checklist for SOLO PARENT IDENTIFICATION
CARD (SPIC)
CATEGORY 6: Nullity/Annulment of Marriage
Requirements:
_______1. Birth Certificate of the Child or
children (1 photocopy)
_______2. Marriage Certificate (PSA or CCR
Certified True Copy); (1 photocopy)
_______3. Judicial decree of nullity or
annulment of marriage or judicial recognition
of foreign divorce; (1 photocopy)
_______4. Sworn Affidavit declaring that the
solo parent has the sole parental care and
support of the child or children at the time of
the execution of the affidavit (1 original)
_______5. Affidavit of a barangay official
attesting that the solo parent is a resident of
the barangay and that the children are under
the parental care and support of the solo
parent applicant. (1 original)
REMARKS:
____________________________________________
____________________________________________
______________________
Prepared by:
_________________________
Reviewed & Approved:
DAISY P. GAVIOLA, RSW
CSWD Officer