Republic of the Philippines)
Makati City )
AFFIDAVIT
I, ______________________, Filipino, of legal age, married, and a resident
of Unit 2 San Isidro Townhomes, San Isidro Drive, Dominga Street, Pasay City,
after being sworn to in accordance with law, do hereby depose and say that:
1. I am married to ________________________ and we have a son named
________________________;
2. Regretfully, our son ________________________ has a disability;
3. After my husband, ________________________, found out that our son was
suffering from a disability, he abandoned us and left us on _____________;
4. Since then, I never heard of him, and I do not know his whereabouts;
5. After my husband abandoned me and my son, I was the only one who
financially supported my son and provided for all his needs and am
raising him as a single parent;
6. I attest that am not cohabiting with anyone and have sole custody of my
son ________________________.
I am executing this affidavit to attest to the truth of the foregoing
statements and for whatever legal purpose it may serve/
IN WITNESS WHEREOF, I have hereunto affixed my signature this
_____________ in the City of Makati, Philippines.
Affiant
SUBSCRIBED AND SWORN TO before me in the City of Makati this
_________ by who exhibited to me her SSS ID with No. containing her
photograph and signature as competent proof of her identity.
Doc. No. ___
Page No. ___
Book No. ___
Series of 2022