ACKNOWLEDGEMENT OF PATERNITY



ACKNOWLEDGEMENT OF PATERNITY

I, Mr. ______________________, a ______________ citizen, of legal age, single/married, temporarily residing at ______________________________________ ,

Malaysia, after having been duly sworn to in accordance with law hereby depose and state:

1. That I am living together with Ms. __________________ , a Filipino citizen with Passport no. _____________ issued on _______________________ at _____________________________________ , Philippines.

2. That out of wedlock was born ____________________________ on __________________ in _______________________________________ ,

Malaysia.

3. That in the Birth Certificate issued by the __________________ Civil Registry, my name was not written as the father since we are not married.

4. That I acknowledge paternity of ___________________________________ .

5. That I execute this affidavit in support to the Report of Birth and passport application of my daughter/son.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __________

Day of __________ 2007 at Kuala Lumpur, Malaysia.

_____________________

Affiant

(Printed name and Signature)

SUBSCRIBED AND SWORN to before me this ________ day of __________ at

Kuala Lumpur, Malaysia. Affiant exhibiting to me his/her I.C./Passport No.: _________________ issued on _______________________________ .

Doc No. :

Series of :

O.R. No. :

Fee :

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