PARENTAL AFFIDAVIT OF BIRTH

I, BON JEFFREY B. GUEVARRA, do hereby swear that I am a parent of

BON CALLEB ESPINELI GUEVARRA.

The other parent’s name is CHARLENE A. ESPINELI.

Further, I swear that the above-named child was born on 04/12/2021 at TANZA

SPECIALISTS MEDICAL CENTER. The child’s mother’s maiden name is CHARLENE

ALEGRE ESPINELI.

The attending physician at the birth was ALMA LOWENA B. ANACAY.

IN WITNESS WHEREOF I have hereunto signed my name this 28th day of October,

2021.

____________________
(Parent’s Signature)

_____________________________
(Relationship)
REPUBLIC OF THE PHILIPPINES )
) SS
CITY OF_________________ )

I, BON JEFFREY B. GUEVARRA being first duly sworn, depose and say:

I am the person above named; I have read the foregoing Parental Affidavit of
Birth and understand the contents thereof; I have executed it freely and voluntarily for
the purpose set forth therein; and I verify the same is true of my own knowledge.

______________________
(Notary Public’s Signature)

SUBSCRIBED AND SWORN to before me this 28th day of October, 2021.

__________________________
NOTARY PUBLIC