REPUBLIC OF THE PHILIPPINES )
MANDALUYONG CITY ) S.S.
SWORN STATEMENT OF SOLO PARENT
I, _________________, of legal age, single, Filipino, and a resident of
__________________________, after been duly sworn to in accordance with law, hereby
depose and state that:
1. I am the mother of ________________________, ____ years of age, and born on
_______________ at _______________________________, who has been under my
care and custody since his birth;
2. His biological father left me sometime in ________ and I have never heard
from him then nor aware of his whereabouts, where I have remained to be
the sole guardian of ____________________;
3. To this day, I remain to be single and unmarried, and is not co-habiting with
any partner, and exercises sole parental care who provides love, care,
guidance, support, and necessities such us food, clothing, shelter, and
expenses for education to _____________________;
4. I am executing this affidavit in order to attest to the truth of the foregoing,
and to for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand and affix my signature this
______________, at Mandaluyong City, Philippines.
___________________
Affiant
SUBSCRIBED AND SWORN to before me this ___________ in the City of
Mandaluyong, affiant who exhibited to me her Competent Evidence of Identity
______________________;
Doc No. _____;
Page No. _____;
Book No. _____;
Series of 2023.