Affidavits

REPUBLIC OF THE PHILIPPINES
[Province/City/Municipality]) S.S.

AFFIDAVIT OF BIRTH

I, [Full Name], of legal age, [civil status], [nationality], and presently residing at [Complete Address], after having been duly sworn to in accordance with law, depose and state:

1. That I am the [relation to the person, e.g., the person whose birth is being declared, a parent, a guardian, or a close relative] of [Full Name of the Person Whose Birth is Being Declared];

2. That [Full Name] was born on [Exact Date of Birth] at [Place of Birth, including Hospital/Clinic or Home Birth, City/Municipality, and Province];

3. That the parents of [Full Name] are [Father’s Full Name], a [citizenship], and [Mother’s Full Name], a [citizenship];

4. That due to [state the reason for lack of birth record, e.g., failure to register, loss of records, late registration, etc.], no official birth certificate was issued or recorded at the time of birth;

5. That I am executing this affidavit to attest to the facts of birth and to comply with the requirements for the late registration of birth with the Local Civil Registrar of [City/Municipality], or for whatever legal purpose it may serve; and

6. That I attest to the truthfulness of the foregoing statements and am willing to provide supporting documents if required.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of [month], [year], at [place of execution].

[Full Name]
Affiant

SUBSCRIBED AND SWORN TO before me in the City/Municipality of [location], this ___ day of [month], [year], by affiant who has satisfactorily proven his/her identity through [Government ID type and number], issued on [date] and expiring on [date], that he/she is the same person who personally signed before me the foregoing Affidavit of Loss and acknowledged that he/she executed the same.

NOTARY PUBLIC

Doc No. ____;

Page No.____;

Book No. ___; 

Series of [YEAR].