Republic of the Philippines

City of Tacloban s.s.

ACKNOWLEDGEMENT AND
RECOGNITION OF USE OF
SURNAME

I, GREGORIO SECOSANA GANZON of legal age, Filipino, with

residence and postal address at the Municipality of Abucay, Province of
Bataan, after having been sworn to in accordance with law hereby depose
and state the following:

1. I hereby acknowledge and recognize GODWIN LAGUILLES

GANZON to be my son. His mother Concepcion Caberic
Laguilles and I lived together for long period giving birth to
three (3) children. Godwin Laguilles was born on March 10,
1985 at Makati, Metro Manila. He is the eldest of the three (3)
children.

2. He, Godwin Laguilles Ganzon, being my son has all the right
the law accords including the use of my surname should he
decides to use the same. Together with this is an affidavit to use
surname of the father in accord with the R.A. 9255 form.

3. I am executing this sworn statement to attest the truth of the

foregoing and to support whatever legal purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this ____

day of _________, 20____ at ________________________.

GREGORIO SECOSANA GANZON

Father-Affiant
I.D. No. _____________
Issued at _____________
Issued on ____________

SUBSCRIBED AND SWORN TO before me a Notary Public in the

City of Tacloban this ____day of __________, 20___.