REPUBLIC OF THE PHILIPPINES}

CITY OF SANTIAGO } S.S

AFFIDAVIT OF ACKNOWLEDGMENT OF PATERNITY

I, RODERICK N. SANTOS, Filipino citizen, of legal age, and presently

residing at Silauan Sur, Echague, Isabela, after having been duly sworn to in
accordance with law, do hereby depose and say:

1. That I am the biological father of the child JAN RICK GALLA who
was born on December 01, 2015 in FEBH Villasis, Santiago City,
Isabela;

2. That at the time of the birth of said child JAN RICK GALLA , I was
not legally married to her biological mother, JANET OLIVAR GALLA
That I hereby acknowledge my paternity/filiation of the child JAN
RICK GALLA ;

3. That, further, I am giving consent for the child to use my surname

and that the same be reflected in his birth certificate;

4. That I am executing this Affidavit to attest to the truth of the foregoing

facts and for whatever legal purpose it may serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto, set my hand this 11 th day of

November 2019 at Santiago City.

RODERICK N. SANTOS
Affiant

SUBSCRIBED AND SWORN to before me this 11th day of November 2019

at Santiago City, Isabela, affiant having exhibited to me his Passport No
P222400B. 00038-0752mac10000 as evidence of his identity.

Doc No. ______;

Page No. _____;
Book No. ____ ;
Series of 2019.