REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SOUTHERN LEYTE ) S.S.

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AFFIDAVIT OF ADMISSION OF PATERNITY

I, ELISEO CARPES TERANTE Filipino, single, of legal age and with residence at
Union, Bontoc, Southern Leyte after having been sworn to in accordance with law
hereby depose and say THAT:

1. I am the biological father of the child named ELAIZA AMOROTO

TERANTE who was born on October 30, 2016 at Rural Health Center
Poblacion, Bontoc, Southern Leyte;

2. At the time of the conception of my child, I was not legally married to her
biological mother, MICHELLE RAMIS AMOROTO;

3. I hereby admit under oath the paternity of the child, ELAIZA AMOROTO
TERANTE she shall henceforth bear my surname, in her Birth Certificate,
School Records, and other legal undertakings to read as ELAIZA
AMOROTO TERANTE and be entitled to all rights of an acknowledged
child/legal heir in pursuant to R.A. 9255;

4. As such, I am executing this Affidavit to attest to the truth of the foregoing

facts and circumstances, and for whatever purpose this may serve.

IN WITNESS WHEREOF, I have hereunto signed my name this

____________________in Bontoc, Southern Leyte, Philippines.

_________________________________
Printed Name and Signature of Affiant

SUBSRIBED AND SWORN to before me this __________________in Bontoc,

Southern Leyte, Affiant exhibited his _______________________with
No.___________________ I certify that I personally examined the affiant and that he
voluntarily executed the foregoing affidavit and understood the contents thereof.