Republic of the Philippines….

)
Buenavista, Agusan del Norte) S.S.
x--------------------------------------x

AFFIDAVIT OF NON-COHABITATION

I, MENOMIE M. BINONGCASAN of legal age, Filipino single resident

Purok 8, Lomboyan, Barangay Guinabsan, Buenavista, Agusan del Norte,
after having been duly sworn with law herby depose and state that;

1. I am currently solo parent as defined under Solo Parents’

Welfare Act of 2000 (RA 8972), Section 4 thereof as amended;

2. I have one (1) child, PRECIOUS MENOMBIE NICOLE

BINONGCASAN DUGLAS who was born on August 23, 2019 in Purok
8, Lomboyan, Barangay Guinabsan, Buenavista, Agusan del Norte as
evidenced by her Certification of Live Birth No. 000201-B19RP03-2
issued on April 28, 2021;

3. Since my child`s birth I HAVE NEVER CO-HABITED WITH

ANY PERSON and has been struggling to make ends meet in
providing sole parental care and support to my child.

4. I am executing his affidavit to attest to the truth of the foregoing

facts and to comply with the documentary requirements in availing the
benefits and privileges accorded to Solo Parents under RA 8972.

IN WITNESS WHEREOF, I have hereunto set my hand this 16th day

of August 2023 at Buenavista, Agusan del Norte, Philippines.

MENOMIE M. BINONGCASAN
Affiant
Solo Parent`s ID No.187-21