REPUBLIC OF THE PHILIPPINES )

CITY OF BAGUIO ) S.S.

SWORN AFFIDAVIT OF SOLO PARENT

I, ROSEMARIE A. DIMAYACYAC, a Filipino citizen of legal age, married,

residing at Brgy. Mapulo, Taysan, Batangas, after being sworn to in accordance
with law, depose and say that:

1. I am the mother of JASMINE A. DIMAYACYAC born on October 1,

2005, LESLIE A. DIMAYACYAC born on July 4, 2007 and LEA A.
DIMAYACYAC born on May 22, 2010 at Mapulo Taysan Batangas ;

2. That his biological father is APOLONIO DIMAYACYAC;

 
3. I am now separated with my husband for almost two (2) years since
2021, he abandoned us without providing any financial support to our child
and I was left solo or alone with the responsibility of taking good care and
providing support for our children.
 
4. Through this Affidavit, I hereby declare under oath that I am the solo
parent and their guardian and the one taking custody and providing
support of the above-mentioned children;
 
5. I am executing this Affidavit to attest to the truth and veracity of the
foregoing and for whatever legal purpose the same may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of

August, 2023 in Taysan, Batangas, Philippines.

ROSEMARIE A. DIMAYACYAC
Affiant
Brgy. ID No. 2023-02

Doc. No. 265 ATTY. KRISELLE S. BALMES

Page No. 53 NOTARY PUBLIC
Book No. XXVIII Notarial Comm. Serial No. 2022-102/12-31-2024
Series of 2023 IBP Lifetime No. 017646/ Batangas Chapter
PTR No. 31725143/01-03-2023 Taysan, Batangas
Roll of Attorney No. 64735
MCLE Compliance No. VII-0028011/04-14-2025
Taysan, Batangas
SUBSCRIBED AND SWORN TO before me this 8th day of August, 2023 in
Taysan, Batangas, Philippines, affiant affiant exhibiting to me their valid
identification card as shown above.