REPUBLIC OF THE PHILIPPINES }
PROVINCE OF ZAMBOANGA DEL SUR } S. S.
MUNICIPALITY OF MOLAVE }
AFFIDAVIT
I, __________________-, Filipino, of legal age, single, and a resident of Molave,
Zamboanga del Sur, after having been duly sworn to in accordance with
law, hereby depose and say, THAT:
1. I am the biological mother of ______________________, minor (3 years
old), born on _______________ at Pagadian City Medical Center,
Pagadian City, Zamboanga del Sur. A copy of her Certificate of Live
Birth is hereto attached as ANNEX “A”, forming an integral part of
this Affidavit;
2. I am executing this Affidavit to support the application of obtaining
her Passport at the Department of Foreign Affairs (DFA) Cagayan de
Oro City and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 10 th day of May
2017 in Molave, Zamboanga del Sur, Philippines.
__________________________
Affiant
SUBSCRIBED AND SWORN to before me this 10th day of May 2017 in
Molave, Zamboanga del Sur, Philippines.
Doc. No.: 343;
Page No: 69;
Book No.:XII;
Series of 2017.
REPUBLIC OF THE PHILIPPINES }
PROVINCE OF ZAMBOANGA DEL SUR } S. S.
MUNICIPALITY OF MOLAVE }
AFFIDAVIT
I, MYRNALYN PAGARAN DAVID, Filipino, of legal age, married and a
resident of Molave, Zamboanga del Sur, after having been duly sworn to in
accordance with law, hereby depose and say, THAT:
1. I am the biological mother of FRAN CHESKA MARIE PAGARAN
DAVID, minor, (10 years old), born on September 22, 2006 at
Mhars Regional Training and Teaching Hosp., Ozamiz City, Misamis
Occidental. A copy of her Certificate of Live Birth is hereto attached
as ANNEX “A”, forming an integral part of this Affidavit;
2. I am executing this Affidavit to support the application of obtaining
her Passport at the Department of Foreign Affairs (DFA) Cagayan de
Oro City and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, We have hereunto set our hands this 10 th day of
May 2017 in Molave, Zamboanga del Sur, Philippines.
MYRNALYN PAGARAN DAVID
Affiant
SSS ID No. 10-0631792-9
SUBSCRIBED AND SWORN to before me this 10th day of May 2017 in
Molave, Zamboanga del Sur, Philippines.
Doc. No.: 344;
Page No: 69;
Book No.:XII;
Series of 2017.