REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI ) S.S.

x-------------------------------------x

AFFIDAVIT OF ILLEGITIMACY

I, MARIA B. DELA CRUZ, of legal age, Filipino, single and a resident of 2222 Washington Street, Pio del Pilar, Makati City, after having been duly sworn to in accordance with law, depose and state:

1. That I am a the mother of Juan Dela Cruz who was born in Davao City on October 5, 2006 as evidenced by the attached Birth Certificate issued by the local civil registrar of Davao City;

2. That my son Juan Dela Cruz was born out of wedlock;

3. That I am not legally married to his father who I no longer have any contact with;

4. That I am executing this affidavit to attest to the above facts and to confirm the illegitimate status of my child;

5. That I am further executing this affidavit to comply with the regulations of the Philippine authorities in connection with his travel to Japan and for all legal purposes and intents beneficial to my child.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

___________________________________

Affiant

Voter's ID No. ___________

SUBSCRIBED AND SWORN to before me, this ____ day of __________ 20____, in the City of __________________, by ___________________ with Passport No.________________ issued on __________________ at _____________.

Notary Public

Doc. No. ______;

Page No. ______;

Book No. ______;

Series of ______;