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REPUBLIC OF THE PHILIPPINES)

BIAN, LAGUNA) s.s.


X__________________________________X

Affidavit of Late Registration


I, RENALYN MACSUSI MACABOCSIT, of legal age,
single, Filipino and a resident of La Solidaridad, Phase III,
Timbao, Bian, Laguna Philippines, after having been duly sworn
to in accordance with law hereby depose and say:
THAT I am the mother of the minor, JANELLE
MACABOCSIT AYON, born on January 6, 2012 who was
conceived and born out of marriage;
THAT the father of my child is JOEY CABACABA AYON,
who is willing and able to acknowledge our daughter as
evidenced by the Affidavit of Acknowledgement of Paternity.
A faithful machine reproduction of the Affidavit of
Acknowledgement of Paternity is hereby attached;
THAT pursuant to this acknowledgement, I can therefore
register the birth of my child JANELLE MACABOCSIT AYON
with the Local Civil Registry of Bian City where she was born;
THAT the reason for the non-registration of the birth
certificate is due to financial constraint and lack of time.
THAT I am executing this Affidavit to attest to the
truthfulness and veracity of the foregoing statements.
FURTHER AFFIANT SAYETH NONE.
IN WITNESS WHEREOF, I have hereunto affixed my
signature this _________of ________ 2015 in________________
Philippines.
Renalyn
Macabocsit
(Affiant)

M.

SUBSCRIBED AND SWORN to before me this ___th day of


_______ at the ___________. I hereby certify that I personally

examined the affiant and that I am satisfied that she voluntarily


executed and understood her affidavit.
NAME
Renalyn M. Macabocsit
_________

CTC NO.
________

DATE

PLACE
__________

NOTARY PUBLIC
Doc. No. .........:
Page No. .........;
Book No. .........;
Series of 2015.

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