Valenzuela City ) S.S.
AFFIDAVIT OF CIRCUMSTANCE OF SOLO PARENT
I, , of legal age, Filipino, with address at 1208 Morong St., Malinta Valenzuela City,
after having been sworn in accordance with law, hereby depose and state:
1. At the age 19, I gave birth to my son, at Malinta, Valenzuela City, on October
14, 2018;
2. That I and the biological father of my son never got married, in fact our
relationship was terminated even prior to me giving birth to my son and have
ever communicated ever since the separation;
3. I was thereafter left alone with the sole responsibility of parenthood but with
the guidance and help of my family and up to present, I am solely providing
for the needs of my son;
4. I am executing this affidavit to attest to the foregoing facts and for the
purpose of securing a solo parent ID and to receive the benefit under the Solo
Parents’ Welfare Act of 2000.
I acknowledge that my eligibility to the benefits provided under the Solo Parents
Welfare Act of 2000 shall immediately cease upon a change in my status of
circumstance as a solo parent.
I am executing this affidavitdeclaration as a requirement for application of Solo
Parent status.
IN WITNESS THEREOF, I have hereunto affixed my signature this 8 th day of May
2018, in the City of Manila
May 22, 2018
Date Signature over Printed Name
Subscribed and sworn to me this 22nd day of May 2018, affiant exhibiting to me her
____________________ issued on ____________________ at _____________________.
Doc. No.____:
Page No.____:
Book No.____: NOTARY PUBLIC
Series of 2018: