Republic of the Philippines)

__________________
)S. S.
____________________
)
------------------x

AFFIDAVIT OF SINGLENESS
I, __________________, of

legal age, _______________ and a resident of

___________________________, after having been duly sworn to in accordance

with law, hereby depose and say;

1. That I am the father of __________________ who was born on

________________at _______________________;
2. That my daughter _________________________ is still single as
_____ has never contracted any marriage with another person
up to the present;
3. That being the father of the said _______________________, I
personally know the circumstances in life of my daughter
_____________________ the fact that prior to her stay abroad, ___
has been staying with us under one roof.
4. That I am executing this affidavit for the truthfulness and to
manifest under oath the foregoing statements.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of
__________________, at __________________.

________________
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of ______, ______
at ___________________________.