REPUBLIC OF THE PHILIPPINES )

Quezon City ) S.S.

AFFIDAVIT OF SOLO PARENT

I, CHARMAINE GILLE, a Filipino citizen of legal age, residing at No. 06 Walnut St.,
West Fairview, Quezon City, after being sworn to in accordance with law, depose and say that:

1. That I am the biological mother of KELLY ANNE GILLE TECSON who was born
on September 30, 2011 at Quezon City;

2. That since my husband died last November12,2021 I’ve been a solo parent to my
child;

3. I was thereafter left alone with the sole responsibility of parenthood but with the
guidance and help of my family and up to present, I am solely providing for the needs
of my child;

4. I am executing this Affidavit to attest to the foregoing facts and for the purpose of
securing a Solo Parent ID / Certification.

IN WITNESS WHEREOF, I have hereunto set my hand this ___day of __________ in

___________________, Philippines

CHARMAINE GILLE
Affiant
ID No. _______________________

Affiant SUBSCRIBED AND SWORN TO before me this _____ day of __________ in

____________City, Philippines, affiant exhibiting to me her competent evidence of identity
indicated below her printed name , bearing her picture and signature appearing therein.

Doc No.:
Page No.:
Book No.:
Series of 2024