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Republic of the Philippines )

Camiling, Tarlac ) S.S.


I, JESUSA D. HILARIO, 60 years old, Filipino citizen and a

resident of Barangay Pinpinas, Santa Ignacia, Tarlac, Philippines, after
having been duly sworn to in accordance with law, do hereby depose
and state THAT:

1. I am the maternal grandmother of ERWIN HILARIO (Erwin, for


2. My grandson Erwin came under my care and custody since birth

after his parents separated ways and her mother went to work
in Manila. Since then up to the present, I took the responsibility
over him, although there is no court order decreeing that I am
her guardian;

3. I am executing this affidavit to attest to the fact that I am the

maternal grandmother and the guardian of Erwin Hilario;

4. Finally, I am executing this affidavit to attest to the truth of the

foregoing statements and for all legal intents and purposes this
may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this 20th day of November, 2017 at Camiling, Tarlac, Philippines.


SUBSCRIBED AND SWORN to before me on the date and place

indicated above. Affiant exhibited to me her Senior Citizen ID Card with
Control No. 05-07490 issued by the Office of the Senior Citizen Affairs,
Santa Ignacia, Tarlac;

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2017.