REPUBLIC OF THE PHILIPPINES

CITY OF MUNTINLUPA

)
) SS.

AFFIDAVIT OF SOLO PARENT

I, ________________________________________, of legal age, Filipino, with
residence and postal address at ____________________________________________
________________________________, after having been duly sworn to in
accordance with law, do hereby depose and says:
1. That I am the legitimate mother/father of the following child/children
namely:
Names
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________

Date/Place of Birth
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

2. That the aforesaid child/children is/are under my care and custody

since his/her/their birth;
3. That his/her/their biological mother/father left me sometime in
____________________ and I have not heard from him/her nor his/her
whereabouts for almost __________ years and I have remained to be the
sole custodian of our child/children;
4. That I stand as the sole parent to my children giving them love, care,
guidance, and providing their basic necessities such as food, clothing,
medicine, etc.
5. That I execute the foregoing affidavit in order to attest the truth of the
above facts for whatever legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand and affix my
signature this ______ day of _________________ in the City of Muntinlupa.

_____________________________
Affiant
SUBSCRIBED AND SWORN to before me this _____ day of ______________
in the City of Muntinlupa affiant exhibited to me his/her Competent Evidence
of Identity bearing his/her picture and signature with ID No.
______________________________ issued by __________________________________.
Doc. No. _____ ;
Page No. _____ ;
Book No._____ ;
Series of 2014.