Republic of the Philippines )

Pasay City, Metro Manila ) S.S.

AFFIDAVIT OF ACKNOWLEDGMENT OF PATERNITY

AND CONSENT TO USE THE SURNAME OF FATHER

I, ANGELO C. DECENA, of legal age, Filipino, and presently

residing at 173 Int. M. Santos St., Barangay 25, Zone 4, Pasay City. after
having been duly sworn to in accordance with law, do hereby depose and
state:

1. That I am the biological father of GRAZIELLA RAFFY PUEDAN

who was born on 26 January 2021 at 2300 Tramo St., Pasay City, Metro
Manila, Philippines;

2. That at the time of the birth of GRAZIELLA RAFFY PUEDAN, I

was not legally married to her biological mother REGINA GRACE S.
PUEDAN;

3. That I hereby acknowledge my paternity/filiation of

GRAZIELLA RAFFY PUEDAN;

4. That I am giving my consent for GRAZIELLA RAFFY PUEDAN

to use my surname and that the same be reflected in his birth certificate;

5. That I am executing this affidavit to attest to the truth and

veracity of the foregoing statemen of fact and to support the claim of my
daughter GRAZIELLA RAFFY PUEDAN with the Local Civil Registrar
(LCR), National Statistics Office (NSO) or Philippine Statistics Authority
(PSA) and for whatever legal intent or purpose it may serve her best.

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

day of ________________, 2022 at Pasay City, Metro Manila

ANGELO C. DECENA
Affiant
ID: Drivers’ License
ID No: NO3-06-002759
Date of Exp 04/27/2023
 SUBSCRIBED AND SWORN to before me this ___ day of ___________
2022, in Pasay City, Metro Manila, Philippines, affiant exhibiting to me
his identifications as indicated above.

Doc. No. ___________

Page No. ___________ NOTARY PUBLIC
Book No. ___________
Series of 2022