Republic of the Philippines )

Province of Palawan )S.S.

City of Puerto Princesa )

AFFIDAVIT OF ILLEGITIMACY

I, MARIA B. DELA CRUZ, of legal age, Filipino, single and a resident of 2222 Washington
Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law,
depose and state:

1. That I am the mother of Juan Dela Cruz who was born in Davao City on October 5, 2006 as
evidenced by the attached Birth Certificate issued by the local civil registrar of Davao City;

2. That my son Juan Dela Cruz was born out of wedlock;

3. That I am not legally married to his father who I no longer have any contact with;

4. That I am executing this affidavit to attest to the above facts and to confirm the illegitimate status
of my child;

5. That I am further executing this affidavit to comply with the regulations of the Philippine
authorities in connection with his travel to Japan and for all legal purposes and intents beneficial
to my child.

IN WITNESS WHEREOF, I have hereunto set my hand this 29th day of August 2013 in
Makati City, Metro Manila, Philippines.

MARIA B. DELA CRUZ

Affiant
Voter's ID No. 5555

SUBCRIBED AND SWORN TO before me this 29th day of August 2013 in Makati City, Metro
Manila, Philippines, affiant exhibiting to me her valid proof of identification.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2013.