_______________________________)

________________________________ )S. S.
 

AFFIDAVIT OF CITIZENSHIP

 I, ____________________________, of legal age, Filipino-

American, and a resident of _________________________, after
having been duly sworn to in accordance with the law, depose
and say:

That I am born on ____________________ to

______________________ who are both Filipino citizens;

That I am the biological mother of _______________________, 
American citizen, born _____________________ in _________________
_;

 That my son is likewise a Filipino citizen because at

the time that he was born, I was considered a Filipino citizen; 

That I reacquired my dual citizenship as Filipino citizenshi
p on ____________; 

That I am executing this sworn affidavit to attest the forego
ing facts in supportof my son`s application for recognition as
Filipino citizen and for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this

_______________________ at _________________________.

________________________
Affiant

SUBSCRIBED AND SWORN to before me this ___________________

at ____________________________. Affiant exhibited to me her
Competent Proof of Identity, ID No. ___________________ issued by
________________.

Doc. No. ____

Page No. ____
Book No. ___
Series of 2021.