AFFIDAVIT OF ACKNOWLEDGMENT OF PATERNITY

AND CONSENT TO USE THE SURNAME OF FATHER

I,
single/ married, and presently residing at,
after having been duly sworn to in accordance with the law, do hereby depose and say:
Filipino citizen, of legal age,
That I am the biological father of the minor/ child
who was born on in
That at the time of the birth of said minor/ child, I was not legally married to his/her biological mother;
IN WITNESS WHEREOF, I hereby affix my signature this day of
in the year in
REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF FOREIGN AFFAIRS
AFFIDAVIT OF ACKNOWLEDGMENT OF PATERNITY
AND CONSENT TO USE THE SURNAME OF FATHER

Foreign Service Post:
NOT FOR SALE
;
.
That I hereby acknowledge my paternity/ filiation of the minor/ child, ;
That I am giving my consent for the minor/ child to use my surname and that the same be reflected in
his/ her birth certificate;
That I am executing this affidavit to attest to the truth of the foregoing facts and for whatever legal
purpose it may serve.
DATE
(Ex. January 01, 2012)
Signature of Father over Printed Name
PHILIPPINE EMBASSY )
CONSULAR SECTION ) S.S.
__________________ )
SUBSCRIBED AND SWORN to before me this day of in the year
affiant having exhibited to me his/her
issued in on and valid until .
passport no.
at the
Doc. No.:________________________
Service No.: _____________________
O.R. No.:________________________
Fee Paid: _______________________