Republic of the Philippines )

City of Makati ) S.S.

x--------------------------x

AFFIDAVIT TO USE THE SURNAME OF THE FATHER/ACKNOWLEDGMENT

I, PABLO S. DELA CRUZ of legal age, Filipino citizen, and presently residing at 7007 M. Ocampo
Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law, do hereby depose
and say:

1. That I am the biological father of JUAN SANTOS.

2. That the biological mother of the child is MARIA L. SANTOS.

3. That my child JUAN SANTOS was born on June 12, 2007 at Cebu City.

4. That the facts of birth of my child were duly registered at the Office of the Cebu City Civil Registrar.

5. That I, PABLO S. DELA CRUZ being the father of JUAN SANTOS, hereby acknowledged and recognized him
as my child and legal heir.

6. That I am allowing my child JUAN SANTOS to use my surname DELA CRUZ to be his surname in
his Certificate of Live Birth.

7. That I execute this affidavit to attest to the truth of the above facts in compliance with the provisions
of Republic Act No. 9255.

IN WITNESS WHEREOF, I have hereunto set my hand this 26th day of July 2013 at Makati City,
Philippines.

PABLO S. DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me this 29th day of July 2013 in the City of Makati,
Philippines, affiant exhibiting to me his competent evidence of identity by way of Philippine Passport No.
12344 issued at Manila, Philippines on September 5, 2011.

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Series of 2013 Notary Public