Republic of the Philippines)

Province of Cebu) S.S.

City of Bogo )
AFFIDAVIT TO USE SURNAME OF THE FATHER
And
AFFIDAVIT OF ACKNOWLEDGEMENT OF PATERNITY

I, ROLANDO LUGTO SARMIENTO of legal age, Filipino citizen, single and presently
residing at Suba, Malbago, Daanbantayan, Cebu, after having been duly sworn to in
accordance with law, do hereby depose and say:

1. That I am the biological father of the following: CJ ALINSONORIN SARMIENTO who

was born on August 22, 2010; ROLANDO ALINSONORIN SARMIENTO JR. who was
born on December 19, 2011 and KAYE ALINSONORIN SARMIENTO who was born on
September 2, 2013;

2. That the aforementioned children were born in Riyadh, Saudi Arabia;

3. That the biological mother of the above-mentioned children is Ivy F. Alinsonorin;

4. That at the time of the birth of my children, I was not legally married to their biological
mother;

5. That the facts of birth of my children were duly registered in Riyadh, Saudi Arabia.
However, the birth records of my children were not subsequently submitted then to
the Philippine Embassy of Saudi Arabia.

6. That I, ROLANDO LUGTO SARMIENTO, being the father of the above-mentioned

children, hereby acknowledged and recognized them as my children and legal heirs.

7. That I am allowing my children namely CJ ALINSONORIN SARMIENTO, ROLANDO

ALINSONORIN SARMIENTO JR. and KAYE ALINSONORIN SARMIENTO to use
my surname “SARMIENTO” to be their surnames in their Certificate of Live Birth.

8. That I execute this affidavit to attest to the truth of the above facts and for whatever
legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at

Bogo City, Cebu, Philippines.

ROLANDO LUGTO SARMIENTO

Affiant

SUBSCRIBED AND SWORN to before me this ___________ in the City of Bogo,

Philippines, affiant exhibiting to me his competent evidence of identity by way of
Philippine Professional Driver’s License No.C10-87-041567 expiry date on
12/27/2016.

Doc No. : _____

Page No.: ______
Book No.: ______
Series of 2016