REPUBLIC OF THE PHILIPPINES . .

]
PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . ….. . . . ]
X - - - - - - - - - - - - - - - - - - - - - - - - -X

AFFIDAVIT OF ACKNOWLEDGMENT /
ADMISSION OF PATERNITY
I, TIMOTEO M. ADONAY, of legal age, Filipino, married and a resident of
Davao City, Davao del Sur, Philippines, after having been duly sworn to in accordance
with law, do hereby declare:

1. That I am the father of MONETH MALABARBAS, who was born

on February 28, 1999 at Davao Regional Hospital, Apokon,
Tagum City to her mother, JAHNETH MALABARBAS;

2. That the Birth Certificate of the child shows that the Family Name
“MALABARBAS” was adopted from her mother’s family name since
JAHNETH MALABARBAS and I were not legally married;

3. That as a natural father of the child, MONETH MALABARBAS, I

hereby acknowledge and declare that she is my true and legal
daughter;

4. That I am executing this affidavit to attest to the truth of the

foregoing facts for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 23 rd day of

January, 2015 at Tagum City, Philippines.

TIMOTEO M. ADONAY
Affiant

SUBSCRIBED AND SWORN to before me this 23rd day of January, 2015 at

Tagum City, Philippines, Affiant exhibited to me his SSS ID Card bearing no. 33-
3579014-7.

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REPUBLIC OF THE PHILIPPINES . . ]
PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
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AFFIDAVIT TO USE THE

SURNAME OF THE FATHER

I, FILJUN A. NACION , of legal age, Filipino, single and a resident of

Longanapan, Laak, Compostela Valley Province, after having been duly sworn to in
accordance with law, do hereby declare:

1. That I am seeking the change of surname in;

a) my Certificate of Live Birth X the Certificate of Live Birth

(b) of

FIONA GRACE ESPAÑOLA, who is my daughter to GERALDINE

L. ESPAÑOLA;

2. That She was born on December 24, 2006 at Bishop Joseph Regan
Memorial Hospital, Tagum City;

3. That the birth above-named child was recorded with the Office of the
Local Civil Registrar of Tagum City, Davao del Norte under Registry
No. 2007-1504;

4. That surname to be changed is from ESPAÑOLA to NACION pursuant

to Republic Act 9255;

5. That I am filing this affidavit at the Office of the City Civil Registrar,
Tagum City , Davao del Norte in accordance with RA No. 9255 and its
Implementing Rules and Regulations;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 17th day

of April 2012 at Tagum City, Philippines.

FILJUN A. NACION
Affiant
Accepted By:
GERALDINE L. ESPAÑOLA
Mother
 SUBSCRIBED AND SWORN to before me this 17th day of April 2012 at
Tagum City, Philippines, Affiant exhibited to me his Driver License No. D16-07-
001384, issued at Tagum City Philippines.
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REPUBLIC OF THE PHILIPPINES . . ]

PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
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AFFIDAVIT OF ACKNOWLEDGMENT /
ADMISSION OF PATERNITY
I, DANIEL TABAS GUIANG, of legal age, Filipino, married to and a resident
of Mawab,Compostela Valley Philippines after having been duly sworn to in accordance
with law, do hereby declare:

1. That I am the father of JASTINE MAMACOS TORREDES, who

was born on August 18, 2007 at Well-Family Midwife Clinic
Nograles Ave. Bucena Davao City;

2. That at the time of the child’s birth, his Birth Certificate shows that
the Family Name “TORREDES” was adopted from his mother’s
family name since I and Airen T. Guiang were not yet legally
married;
 3. That as a natural father of the child, JASTINE MAMACOS
TORREDES, I hereby acknowledge and declare that he is my true
and legal son;

4. That I am executing this Affidavit to attest to the truth of the

foregoing fact and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 10th day

of January 2011 at Tagum City, Philippines.

DANIEL TABAS GUIANG

Affiant

SUBSCRIBED AND SWORN to before me this 10th day of January 2011 at

Tagum City, Philippines, Affiant exhibited to me his Community Tax Certificate No.
___________ issued on _______________ , 2011 at Tagum City, Philippines.

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Series of 2011

REPUBLIC OF THE PHILIPPINES . . ]

PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
X - - - - - - - - - - - - - - - - - - - - - - - - -X
Registry No. ___________

AFFIDAVIT TO USE THE

SURNAME OF THE FATHER

I, DEMMY A. DEL VALLE, of legal age, Filipino, married and a resident of

Purok Katuparan, Teacher’s Village, Tagum City, after having been duly sworn to in
accordance with law, do hereby declare:
 1. That I am seeking the change of surname in the Certificates of Live
Births of my following children who were born out of wedlock to their
mother, Maria Teresa C. Pumar , to wit:`

Name Date of Birth Place of Birth Registry No. Date Registered

MARIE DHEL PUMAR August 17, 1994 Tagum City 94-3652 Sept. 8, 1994
DEXTER PUMAR September 9, 1998 Tagum City 98-5696 Oct. 7, 1998

2. That their respective births were recorded at the Office of the City Civil
Registrar, Tagum City

3. That the surname to be changed is from PUMAR to DEL VALLE

pursuant to Republic Act 9255;

4. That I am filing this affidavit at the Office of the City Civil Registrar,
Tagum City in accordance with RA No. 9255 and its Implementing Rules
and Regulations;

5. That I hereby certify that the statements made herein are true and correct
to the best of my knowledge and belief.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 31st day of

January 2006 at Tagum City, Philippines.

DEMMY A. DEL VALLE

Affiant

SUBSCRIBED AND SWORN to before me this 31st day of January 2006 at

Tagum City, Philippines, Affiant exhibited to me his Community Tax Certificate No.
17769085 issued on January 31, 2005 at Tagum City, Philippines.

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Series of 2005

REPUBLIC OF THE PHILIPPINES . . ]

PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
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Registry No. ___________

AFFIDAVIT TO USE THE

SURNAME OF THE FATHER
 I, RUBEN P. REGODON, of legal age, Filipino, single and a resident of
Purok Calachuchi, Visayan Village, Tagum City, Philippines, after having been duly
sworn to in accordance with law, hereby depose and say :

2. That I am seeking the change of surname in the Certificates of Live

Births of my following children who were born out of wedlock to their
mother, PERLITA L. LOPECILLO, to wit:`

Name Date of Birth Place of Birth Registry No. Date Registered

RONNIE LOPECILLO May 29, 1994 Tagum City 94-2536 June 28, 1994
DONDY LOPECILLO March 1, 1996 Tagum City 98-4518 Aug. 10, 1998

6. That their respective births were recorded at the Office of the City Civil
Registrar, Tagum City

7. That the surname to be changed is from LOPECILLO to REGODON

pursuant to Republic Act 9255;

8. That I am filing this affidavit at the Office of the City Civil Registrar,
Tagum City in accordance with RA No. 9255 and its Implementing Rules
and Regulations;

9. That I hereby certify that the statements made herein are true and correct
to the best of my knowledge and belief.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th day of

March, 2005 at Tagum City, Philippines.

RUBEN P. REGODON
Affiant

SUBSCRIBED AND SWORN to before me this 5th day of March, 2005 at

Tagum City, Philippines, Affiant exhibited to me his Community Tax Certificate No.
12975452 issued on April 5, 2005 at Tagum City Philippines.

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Series of 2005

REPUBLIC OF THE PHILIPPINES . . ]

PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
X - - - - - - - - - - - - - - - - - - - - - - - - -X
Registry No. ___________

AFFIDAVIT OF ACKNOWLEDGMENT /
ADMISSION OF PATERNITY
I, DEMMY A. DEL VALLE, of legal age, Filipino, married to and a resident of
Purok Katuparan, Teacher’s Village, Tagum City, after having been duly sworn to in
accordance with law, do hereby declare:

5. That I am the father of MARIE DHEL PUMAR, who was born on

August 17, 1994 at Tagum City;

6. That at the time of the child’s birth, her Birth Certificate shows that
the Family Name “PUMAR” was adopted from her mother’s family
name since I and Maria Teresa C. Pumar were not yet legally
married;

7. That as a natural father of the child, MARIE DHEL PUMAR,

I hereby acknowledge and declare that she is my true and legal
daughter;

8. That I am executing this Affidavit to attest to the truth of the

foregoing fact and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 31st day of

January 2006 at Tagum City, Philippines.

DEMMY A. DEL VALLE

Affiant

SUBSCRIBED AND SWORN to before me this 31st day of January 2006 at

Tagum City, Philippines, Affiant exhibited to me his Community Tax Certificate No.
17769085 issued on January 31, 2005 at Tagum City, Philippines.

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Series of 2005
REPUBLIC OF THE PHILIPPINES . . . ]
PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
X..............................X

AFFIDAVIT OF ACKNOWLEDGMENT /
ADMISSION OF PATERNITY

I, JOEL B. BALANSAG, of legal age, Filipino, single and a resident of Purok

Maligaya, Mankilam, Tagum City, after having been duly sworn to in accordance with
law, do hereby declare:

9. That I am the father of JOSHUA DURANGO, who was born on

February 16, 2005 at Davao Regional Hospital, Tagum City;

10. That at the time of the child’s birth, his Birth Certificate shows that
the Family Name “DURANGO” was adopted from his mother’s
family name since I and Jessie B. Durango were not yet legally
married;

11. That as a natural father of the child, JOSHUA DURANGO, I

hereby acknowledge and declare that he is my true and legal son;

12. That I am executing this Affidavit to attest to the truth of the

foregoing fact and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th day of

January 2005 at Tagum City, Philippines.

JOEL B. BALANSAG
Affiant

SUBSCRIBED AND SWORN to before me this 9th day of January 2006 at

Tagum City, Philippines, Affiant exhibited to me his Community Tax Certificate No.
17785053 issued on January 9, 2006 at Tagum City, Philippines.

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Book No. _______
Series of 2006
REPUBLIC OF THE PHILIPPINES . . ]
PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
X - - - - - - - - - - - - - - - - - - - - - - - - -X

Registry No. ___________

AFFIDAVIT TO USE THE

SURNAME OF THE FATHER

I, JOEL B. BALANSAG, of legal age, Filipino, single and a resident of Purok

Maligaya, Mankilam, Tagum City, after having been duly sworn to in accordance with
law, do hereby declare:

2. That I am seeking the change of surname in;

a) my Certificate of Live Birth X the Certificate of Live Birth

(b) of

JOSHUA DURANGO, who is my son to Jessie B. Durango;

6. That he was born on February 16, 2005 at Tagum City;

7. That the birth above-named child was recorded with the Office of the
Local Civil Registrar of Tagum City under Registry No. 2005-1649;

8. That surname to be changed is from DURANGO to BALANSAG

pursuant to Republic Act 9255;

9. That I am filing this affidavit at the Office of the City Civil Registrar,
Tagum City in accordance with RA No. 9255 and its Implementing Rules
and Regulations;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9 th day of

January 2005 at Tagum City, Philippines.

JOEL B. BALANSAG
Affiant
 SUBSCRIBED AND SWORN to before me this 9th day of January 2006 at
Tagum City, Philippines, Affiant exhibited to me his Community Tax Certificate No.
17785053 issued on January 9, 2006 at Tagum City, Philippines.

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Series of 2005

REPUBLIC OF THE PHILIPPINES . . . ]

PROVINCE OF DAVAO DEL NORTE ] S.S.
CITY OF TAGUM . . . . . . . . . . . . . . . . ]
X..............................X

AFFIDAVIT OF ACKNOWLEDGMENT
I, JUNREY L. GEMENTIZA, of legal age, Filipino, single and a resident of
Purok Ipil-ipil, Magugpo East, after having been duly sworn to in accordance with law,
do hereby declare:

13. That I am the father of JOYCE CAMILLE IMBOC who was born
on September 14, 2004 at Davao Regional Hospital, Tagum
City;

14. That at the time of the child’s birth, her Birth Certificate shows that
the Family Name “IMBOC” was adopted from her mother’s family
name since I and Erliza Marie B. Imboc were not yet legally
married;

15. That as a natural father of the child, JOYCE CAMILLE IMBOC,

I hereby acknowledge and declare that she is my true and legal
daughter;

16. That I am executing this Affidavit to attest to the truth of the

foregoing fact and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th day of

September, 2005 at Tagum City, Philippines.
 JUNREY L. GEMENTIZA
Affiant

SUBSCRIBED AND SWORN to before me this 5th day of September, 2005 at

Tagum City, Philippines, Affiant exhibited to me her Community Tax Certificate No.
17737969 issued on September 5, 2005 at Tagum City, Philippines.

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Series of 2005

We, JEVANIE V. SUSAS and AMELITA B. STA. IGLESIA, both of

legal age, Filipino, husband and wife respectively, and residents of Kingking,
Pantukan, Comval Province, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and say:

1.That at the time when our child NIÑO STA. IGLESIA, was
conceived, we could have contracted marriage as there were no
legal impediments for us to marry each other;

2.That said child NIÑO STA. IGLESIA was born on July 29,
2004 at Tagum City whose birth was duly registered at the
Office of the Local Civil Registrar of Tagum City under Registry
No. 2004-6284;

3.That we entered into a contract on February 14, 2005 at

Kingking, Pantukan, Comval Province, and that our
marriage was solemnized by Rev. Michelangelo B. Atabelo;

4.That the fact of our marriage was duly registered with the
Office of the Local Civil Registrar of Pantukan, Comval
Province under Registry No. 2005-113;
 5.That we are executing this Affidavit to attest to the truth of the
foregoing facts and to support the legitimation of the above-
named child with the Office of the Local Civil Registrar of
Tagum City.

IN WITNESS WHEREOF, we have hereunto set our hands this 18 th of

July, 2005 at Tagum City, Philippines.

JEVANIE V. SUSAS AMELITA B. STA. IGLESIA

Affiant Affiant

SUBSCRIBED AND SWORN to before me this 18 th day of July, 2005 at

Tagum City, Philippines. Affiants exhibited to me their Community Tax
Certificates No. 02214249 and 02214248, respectively, both issued on January
31, 2005 at Pantukan,