Republic of the Philippines

Province of Leyte
City of Tacloban

)
) SS
)

JOINT AFFIDAVIT
RE: PROOF OF CUSTODY

We, RUBEN M. SIOZON and JOAN ANICIETO, both of

legal ages, Filipinos, and with postal address at c/o God Send
Grocery, corner Real and Sampaguita Sts., Tacloban City and
Culaba, Biliran respectively, after being first sworn according
to law, hereby depose and state: THAT--1. From our relationship, our son JAN ROBBIE SIOZON
was born on June 17, 2005 in Tacloban City.
2. Our son JAN ROBBIE SIOZON has been in the custody
of his father, RUBEN M. SIOZON for the past three (3) years
now, as he is the one assuming all the obligations based in
our verbal custody agreements.
3. For the best interest of our son JAN ROBBIE SIOZON,
we intend to move him to Canada with his father, who is a
permanent resident, and where he too is free to move,
without the objection of his mother.
4. We are executing this Affidavit to attest to the truth
of the foregoing facts in compliance of the requirements on
Childrens Information on Appendix A (Document Checklist
for Immigrant).
IN WITNESS WHEREOF, we have hereunto set our
hands this 16 June 2010 at Tacloban City, Leyte, Philippines.
RUBEN M. SIOZON

JOAN ANICIETO

SUBSCRIBED AND SWORN to before me this 16 June

2010 at Tacloban City, Philippines, by RUBEN M. SIOZON,
who has satisfactorily proven his identity to me through his
Canada Permanent Resident Card No. 5248-2462 to expire
on 23 August 2011 and JOAN ANICIETO who has exhibited to
me
her
competent
identity
through
_____________________________________________.
Doc. No. 453
Page No. 91

Book No. 58
Series of 2010