CONSULATE GENERAL OF THE )

REPUBLIC OF THE PHILIPPINES) S.S.

HONG KONG SAR
)

AFFIDAVIT OF ADMISSION OF PATERNITY AND

CONSENT TO USE SURNAME OF FATHER
I, _________________________________________________, a citizen of
_______________________, of legal age, and presently residing at ______________
____________________________________________________________________,
after having been duly sworn to in accordance with law, do hereby depose and state:
That I arrived in Hong Kong/Macao on _______________________ and I am
now a holder of _______________________________ (please state status of stay in Hong Kong
/Macao employment visa, unconditional stay, or right of abode);

That I am presently employed at _____________________________________

_________________________ as ________________________________________;
That sometime in __________________, I met _________________________
a Filipino national, with whom I later had a relationship with;
That as a result of this relationship, she conceived and gave birth to a child on
_______________________ in ______________________, and we named him/her
_____________________________________;
That I am not legally married to Ms. _________________________________,
the mother of my child, in accordance with Philippine laws;
That I hereby admit under oath the paternity of _____________________; and
That I further acknowledge that I am the natural father of said child and I am
willing to give him/her all his/her rights as my child under the laws of the Philippines,
including the right to carry and use my surname ____________________________
as his/her own pursuant to Republic Act No. 9255.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ______day
of ________________________ 20___ in Hong Kong SAR / Macao SAR.
_________________________
Affiant
SUBSCRIBED AND SWORN to before me this _____ day of ______________
20__ in Hong Kong SAR, affiant exhibiting to me his Philippine Passport/ Hong Kong/ Macao
identity card no. ____________________ issued on ____________________
in ________________________________.
Doc. No.
Page No.
Book No.
Series of
Svc. No.
O.R. No.
Fee Paid

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