REPUBLIC OF THE PHILIPPINES)

City of Digos )s.s

AFFIDAVIT OF BARANGAY OFFICIAL

I, , of legal age, Filipino, and with residence address
(Punong Barangay)

at Purok , Barangay , Digos City, Davao del Sur, after having duly sworn
to in accordance with law, hereby depose and state that:

1. I am an incumbent/elected Punong Barangay , of Barangay ,

Digos City;

2. Ms./Mr. is applying for Solo Parent Identification

Card before the City Social Welfare and Development Office of Digos City for the
benefits granted by Republic Act 11861 also known as the “Expanded Solo Parent
Welfare Act of 2022”;

3. Ms./Mr. is a legitimate residence of Barangay since

for years with present address at Purok ;
4. Ms./Mr. is the of the following
(Father, Mother, Guardian)
minor/children;

Name Age Birthdate

a.
b.
c.
d.
e.

5. I am executing this affidavit to attest the truth of the foregoing and to confirm that
Ms./Mr. is a qualified solo parent under the
category as provided under Republic Act 11861 and she/he is
neither cohabiting any person nor has a co-parent and the above-mentioned minor
children is under his/her sole parental care and support;

IN WITNESS WHEREOF, I have hereunto set my hands this day of 2024

in Digos City, Davao del Sur.

Affiant

SUBSCRIBED AND SWORN to me before this day of 2024 in Digos City,

Davao del Sur. Affiant exhibiting to me his/her .

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