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REPUBLIC OF THE PHILIPPINES}

MUNICIPALITY OF TANZA } S.S.


PROVINCE OF CAVITE }

AFFIDAVIT

I, DANIEL WEBSTER RIVERA FINGERHUT, of legal age, single and


presently residing at De Roman Subdivision, Barangay Daang Amaya I, Tanza, Cavite, after
having been sworn to in accordance with law, depose and state that:

1. I was born on July 7, 1993 in Our Savior Hospital, Rosario, Cavite, Philippines by my
parents Spouses DAVID GENE FINGERHUT, an American Citizen and MARIA RUBYCINIA ARCA
RIVERA, Filipino Citizen;

2. Since my mother is a Filipino citizen, it is my intention in good faith to declare and


hereby manifest that since time immemorial, I honestly believe that I am a citizen of the Republic of the
Philippines although I am likewise a holder of travel passport issued by United States of America since
my father is an American Citizen;

3. Up to this present day, I have grown to love and appreciate the beauty of this country and
hereby declare under oath that I am a faithful and patriotic citizen of the Republic of the Philippines;

4. I hereby vouch to uphold the constitution, the laws, and the authority of the dully
constituted authorities herein;

5. Based on the foregoing declarations, I hereby truthfully and wholeheartedly declare that
for all intents and purposes, I intend to be a holder of Philippine citizenship and have always believed in
the principles underlying the Philippine Constitution;

6. I am executing this affidavit to attest to the truth of the foregoing and for whatever legal
purposes and intent it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of March, 2014 at the
Municipality of Tanza, Cavite, Philippines.

DANIEL WEBSTER RIVERA


FINGERHUT
AFFIANT

SUBSCRIBED AND SWORN to before me this 6TH day of March, 2014, in the Municipality of
Tanza, Province of Cavite, Philippines, affiant exhibiting to me his passport bearing no. 510080016
issued on November 22, 2013 in USA.

ATTY. SHERILYN V. PINPIN-ARCA


NOTARY PUBLIC
VALID UNTIL December 31, 2014
PTR No. 4529873; January 2, 2014; Cavite
IBP No. 929685; December 27, 2013; Cavite
Roll of Attorneys No. 53995

Doc.No. _____;
Page No. _____;
Book No. XII;
Series of 2014.

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