Republic of the Philippines)

City of Binan, Laguna

) S.S.
AFFIDAVIT OF PATERNITY AND CONSENT
TO USE THE SURNAME

I, JOEY CABACABA AYON, Filipino, of legal age, married,

and a resident of La Solidaridad Phase III, Timbao, Binan City,
Laguna, after having been sworn in accordance with law, do
hereby respectfully depose and state:
That I am the biological father of the minor, JOEY ANNE
MACABOCSIT AYON that was born on October 11, 2010 in
Binan City, Laguna;
That at the time of the birth of said minor, I was not legally
married to her biological mother;
That I hereby acknowledge paternity to the aforesaid minor;
That I am giving my consent for the minor to use my
surname AYON and that the same be reflected in her birth
certificate;
That I am executing this Affidavit to attest to the truth of
the foregoing facts and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand
this _____________ at _____________ City, Philippines.
JOEY CABACABA AYON
(Affiant)
JURAT/CERTIFICATION
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 he voluntarily
executed and understood his affidavit.
NAME
PLACE
Joey Cabacaba Ayon
________

CTC NO.
______

DATE
_______

NOTARY PUBLIC

Doc. No. .........:

Page No. .........;
Book No. .........;
Series of 2015