REPUBLIC OF THE PHILIPPINES )

CITY OF BAGUIO
) S.S.
AFFIDAVIT
I, _______________, of legal age, Filipino, married and a Social
Worker of the
Reception and Study Center for Children,
__________________ after having been duly sworn to in accordance
with law do hereby depose and say that:
On ____________ a man named ___________, a scrapper/junkshop
owner by profession and ____________ went to ___________Police
Station to surrender a baby he found;
Our ___________ at Puguis, La Trinidad was informed by
_____________ of this matter and to surrender the baby to our
custody and care;
We found out that the baby was found on a stairway of
____________. Upon verification we found out that the umbilical cord
of the baby was still uncut and was wrapped in a wet and bloody
bed sheet. When the baby weighed at 2 kilograms with normal
temperature at 36.4 degrees Celsius;
The given name of the baby was ___________, she was newly
born when found and her given date of birth was that of August 8,
2015;
____________ did not execute any affidavit of foundling to
support the declaration and process for the baby to be declared
legally free for adoption. We tried to find him for this process with
the assistance of the ____________ Police Station 2 but to no avail;
I am therefore executing this AFFIDAVIT OF FOUNDLING to
support the legal process of declaring ______________ legally free for
adoption and to support any application for her adoption and for all
legal intents and purposes.
IN WITNESS WHEREOF I hereunto set my hand this 22 nd day of
July 2016 at Baguio City, Philippines
_________________
Social Worker
_______________
SUBSCRIBED AND SWORN to before me this 22 nd day July 2016
at __________________, Philippines.