AFFIDAVIT OF PATERNITY

I, _________________________________, of legal age, ____________,

____________,
(status)
(citizenship)
and
a
resident
of
_________________________________________________________
and with telephone no. ________________, Passport No._________________
issued
on _____________________ in _____________________, having been duly
sworn to
in accordance by law do hereby depose and say:
1.

That I am the father of the child ______ __________________,

born on

______________________
__________________________________;

in

2.

That the mother is _____________________________a citizen of

the
Philippines;

3.

That I acknowledge to support my son/ daughter and allow the use

of my surname ;

4.

That this affidavit is being executed for the purpose of attesting to

the
truth of the facts above stated and for whatever legal purpose it
may
serve.

AFFIANT FURTHER SAYETH NAUGHT.

_________________________________

Signature of Affiant over Printed Name

SUBSCRIBED AND SWORN to before me this
_________________ in the City of Shanghai, China.
Doc. No.
Service No.
Page No.
Series of

________
________
________
________

_________

day

of