Republic of the Philippines )

City of Dagupan ) S.S.

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

AFFIDAVIT TO USE THE SURNAME OF THE

FATHER/ACKNOWLEDGMENT

I, MONY ALMEROL BADUA, of legal age, Filipino citizen, and presently

residing at T. Celis Street, Germinal, Bolinao, Pangasinan, after having been duly
sworn to in accordance with law, do hereby depose and say:

1. That I am the biological father of JOHAR MEO CASTILLO BADUA.

2. That the biological mother of the child is PERLITA UNTALAN

CASTILLO.

3. That my child JOHAR MEO CASTILLO BADUA was born on 22

September 2018 at Region 1 Medical Center, Arellano, Dagupan City.

4. That the facts of birth of my child were to be registered at the Office of

the Local Civil Registrar – Dagupan City.

5. That I, MONY ALMEROL BADUA, being the father of JOHAR MEO

CASTILLO BADUA, hereby acknowledged and recognized him as my child
and legal heir.

6. That I am allowing my child JOHAR MEO CASTILLO BADUA to use

my surname BADUA 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 24th day
September 2018 at Dagupan City, Philippines.

MONY A. BADUA
Affiant
VIN: 5514-0004A-C2883MAB10000

SUBSCRIBED AND SWORN to before me this 24th day of September 2018 in

Dagupan City by Mony A. Badua, who has satisfactorily proven his identity to me
through his government-issued ID, which is written below his name, that he is the
same person who personally signed the foregoing instrument before me and
acknowledged that he executed the same.

CRESENCIO D. DELA CRUZ, JR.

OIC/Public Attorney III
Pursuant to RA No. 9406