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*:
$r"
Ir
Fn MTI-I .+*-..*;d..X'{ Legitimated by subsequent
{l',ll {ilrl aioxfipletely, sfirurthlolY an{l Us€
Plac*l H rlh* t i,:rto
frraffa ge of parents on
F'ebruaty 4,1999 at the
eity tvl il Lt_ CT TtrHY-0r26 Regional Trial Court, Br
x" l,lAMl: {First) (lliCdle) (Last)
ALec Maverlck MaraLLt 32,SanPablo City. The
(1m!' j-1. IlAf[: Sttr Blfilll (dav) (rnonth) (yeat) child shall be known as
"i ,**X-. t Malo .*- A Female 27 Oct. 7997 ..ALEC MAVERICK
{h
,1" Iti l\,t-.1 I. il (l,,iarrio i,}f lfurs6}i{all{llinir;/lrrstiluliorrf (t.li ty/ M u n i()i p ;.tl i ty) (Pmivince)
MARALIT CASTRO"
hi liili l l iir.:rtl;tr lllr.,ljtrr::,lt, tjlaranltay)
I Paninsinqln, Tambo Llpa City BatanEas
t "TYP
$F MIRTH tr, li; fl,/tLJL"l'lllt..t: f*lHfH, Cl]lLD WAIS
m
Sm".
x H lSingle -*.-._2'Iwin *-*..' I first *-_--_ 2 $e*$nd Reg. No.2002-252
-.- 3 Triplet. eie . -.*-*. 3 0thers rf
:.

{;. Llli:l I }'i i[]jllL:f1 (liv* iiirtlrs rrrrJ fr:tal d*alhs d. Wl.rlGl-{]" AT BlftTFl
irch ir:lint] this rlelivery) -- -
1P!, ._. - ({ir$t, aEsqrrrJ, tlrird, eto.} 2fr9 ."
fi. ft/lffm[:.r.1 (Firat) (i,.ilidrlle) (l-asl)
,t'i
I{AMF AiIene R,r Maralit
7" slTrzi:r{$FllP pil. ,.:::. . ,.,

.s6

$4. Totalnurmberof
ehildren Lrorn 'L
Lt. lrlc.n{childreneLill
living including 1"
f i_] i #li
"10" f;CISLl['ATlOt'l 11 ASe at thB tilno
Employee oltlris trirlh: 25

12" Aff$il".r[:r{CH (t loLrso f,Jo., Street, Enrangey)


P an Tarnbo
TT

13" t'{AtutF (Fiirntl (Mieldlo):':i':'i I "r ([asti


tr; :^\Ja Castro
A
'r 1 4" 0tTl7_"f. r.lst-lll3 15. HHLIGIOhI :l
NC
p"l

r' 1S" fiect?PAnfiN 17. Age at th€ tinr8


Employee of this trirth: 27
yeaJ$
ffi
&
1fi. tlA"ft ,'!.i'lD $)LAfif: 0f:: MAlrRtA(lr, (lf not rnarriorl AflirJavit ei{

i',', r ttvrl+rl-{irn*rt1- of l3alnrnity al the back.)


I{ot married
1Sa, A'ITE!'{llANT. il
3 Miciwifa
t)
A Nurse .]*1**
*JC*-, F{ilot llt.ilidwife) 5
i
1Sb. cffiRTlriffiATtSF{ Qrj [il
Itle.rny certify that I attencled the bidh of *re ehiio *trowisf,orn arile ar* -..-_ o'erbdk
{1CI I
IT /\
Y- L'
-liiOSeu
am/prn on tlr,. ({ats stated above.

hrgn r:itut0 Adrlress _U&RE--Ug-tuPg r--I"i-PA-C


hlanle h Frrint.
Title nr Fositi*; r
tr:ad" f6
Uale
I , ::li:.ii'ii
fr fi " lr"Ir:0t:{ rL'ipohlT,
/
sis:natunoa- Address
l'Xarn* in Print :
:li. ii rii
Relatianship -t,:

2n" FREIIAFEED SY;r':j' ':, "rJ:-"' 1


ri. p2" t,tticHlvfin 0F'
TI.{E CIVIT
i,

Signaturo ** .!iq;naturtt
Mr LTI'TDO Narne in Frint
hlanre in Frint
Titlq or Fnsil.io,l
'l'itle or Fnsiti(]n t
ZT 0a ,?-/
LJat*

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