Republic of the Philippines )
___________……………………)SS.
x-------------------------------x
AFFIDAVIT OF GUARDIANSHIP
I, ______________________, of legal age, Filipino and a resident of
______________________________, after having been duly sworn to in
accordance with law, do hereby depose and state:
1. That I am the guardian/custodian of the minor named
___________________, who was born on ______________ at
__________________________, to his/her biological parents
_________________ and ______________________;
2. That the said child has been under my guardianship and custody for
________ months/years because ___________________________;
3. That I am the only one been providing/supporting her basic needs; And,
4. That I am executing this Affidavit to attest the truthfulness of the
foregoing statements and for whatever legal purpose this may serve;
IN WITNESS WHEREOF, I do hereby set my hand this
___________________ in _________________________.
________________
Affiant
SUBCRIBED AND SWORN to before me this _________________ in
______________________. Affiant appeared before me, exhibited to me her
___________________ ID No. _____________ issued by __________________
and is personally known to me.
NOTARY PUBLIC