REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO ) S.S

PROVINCE OF LA UNION )

AFFIDAVIT TO USE THE SURNAME OF THE FATHER

I, FFF, of legal age, married, Filipino citizen and a resident of San Fernando City,
La Union after having been duly sworn to in accordance with law, do hereby depose
and say that:

1. I am the biological father of DD;

2. My child was born out of wedlock on October 2, 1997 at of Ilocos Regional
Hospital, San Fernando City, La Union;
3. The facts of birth of my child was duly registered at the Office of the Civil
Registrar of San Fernando City, La Union;
4. I recognized her as my child in her birth certificate a copy of which is here to
attached as Annex “A”;
5. MM and I actually contracted marriage subsequently on October 9, 2001 at
San Fernando City, La Union a copy of which is hereto attached as Annex
“B”;
6. The marriage was duly registered at the Local Civil Registrar of San Fernando
City, La Union under Registry No. 20010827;
7. At the time our daughter was born, we have no legal impediment to marry
each other;
8. That by virtue of our subsequent marriage, DD had been legitimated and
bestowed with all rights and privileges pertaining to a legitimate child,
including the right to use the surname of the father such that she is already
known as DDFF; and
9. That I am executing this affidavit to request the Local Civil Registrar to
amend the birth certificate of our child so that her legal name DDFF should
reflect in said Birth Certificate to attest to the truth of all the foregoing facts
and likewise for all legal intents and purposes;

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of July,
2018 at San Fernando City, La Union.

FF
AFFIANT-FATHER
ID NO.______________

SUBSCRIBED AND SWORN to before me, this ____ day of___, 2018 at San
Fernando City, La Union, affiant exhibiting to me his ID as stated above.

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