Republic of the Philippines )

Province of Cebu ) S.S.

AFFIDAVIT OF SOLO PARENT

I, DELIA BELACHO DONAIRE, of legal age, Filipino, and residing in San Jose, Poro,
Cebu, after having been duly sworn to in accordance with law, do hereby depose and say:

1. That I am the mother of James Vine Donaire, nineteen (19) years old, who was born on
June 03, 2003 in San Jose, Poro, Cebu, and Cherlan Donaire, nine (9) years old, who was
born on January 21, 2013;

2. That my husband died on August 27, 2017;

3. That I am already a member of the SOLO PARENT of the Municipal Social Welfare
Office of Municipality of Poro, Cebu;

4. That I was already issued a Solo Parent I.D. with I.D. No. 653;

5. That since at the moment up until to the present, I am in custody of my children;

6. That I was thereafter responsible for the needs of my children;

7. That at present I have the sole parental care and support of my children;

8. That I am executing this affidavit to attest the truth of the foregoing facts and
requesting the Municipal Social Welfare Department Office of Municipality of Poro,
Cebu for the reissuance of a Solo Parent ID and to receive the benefits under the Solo
Parent Welfare Act.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 25th day of March
2023, in the Municipality of Poro, Cebu, Philippines.

DELIA BELACHO DONAIRE

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this 25th day of March 2023,
in the Municipality of Poro, Cebu Philippines. Affiant exhibited to me her National ID
no. 6510-5830-7497-5048, as competent proof of her identity.

Doc No.
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Book No.
Series of 2023.