REPUBLIC OF THE PHILIPPINES )

CITY OF PARA AQUE ) S.S

METRO MANILA )

AFFIDAVIT OF ADMISSION OF PATERNITY

I, ________________________, of legal age, single/married,

Filipino and a resident of __________________________, after
having been duly sworn to in accordance with law, do hereby depose and
state that:

1. I am the biological father of the child named

____________________ who was born outside of wedlock on
_______________ at _________________________;

2. At the time of the conception of my child, I was not legally married

to his/her biological mother named ___________________;

3. I hereby admit under oath the paternity of the child

________________. he shall henceforth bear my surname
________________ in his Birth Certificate, School Records and
other legal undertakings to read as ( NAME OF CHILD AND
ADD SURNAME OF FATHER ) and be entitled to all the rights
of an acknowledged child/legal heir pursuant to R.A. 9255; And,

4. I am executing this Affidavit to establish the truth of the foregoing

facts and circumstances and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I do hereby set my hand this

____________ in _______________.

______________________________
Affiant

SUBSCRIBED AND SWORN to before me this

_____________ in __________________. Affiant exhibited
to me competent evidence of identity (ID No.
_____________________).