REPUBLIC OF THE PHILIPPINES)

City of Baguio) S.S

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

AFFIDAVIT OF ILLEGITIMACY

I, Teresita Lumabas, Filipino, of legal age, single, and a resident of

#122 Lopez Jaena St., Aurora Hill, Baguio City, after having been
duly sworn in accordance with law, hereby depose and state:

1. That I am the mother of Cerafica Lumabas who was born on

April 9, 2010 at the Notre Dame de Chartres Hospital, Baguio
City;

2. That my daughter Cerafica Lumabas was born out of wedlock;

3. That I am not married with her father since he is already

married;

4. That I have no communication with her father and has no

information about his whereabouts;

5. That I am executing this affidavit to attest to the above facts and

to confirm the illegitimacy of my daughter;

6. That I am further executing this affidavit to comply with the

regulations of the Philippine authorities in connection with her
travel to Stockholm, Sweden

.
IN WITNESS WHEREOF, I have hereunto set my hand this 17 th of
January 2017, at the Marquez Law Office, 304 Porta Vaga Bldg.,
Baguio City, Philippines.

Teresita Lumabas
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and

for the City of Baguio this 17th of January 2017. Affiant personally

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came and appeared with her non-professional drivers license with
license number N25-12-004694 issued by the Department of
Transportation and Communication, Land Transportation Office on
April 2, 2016 at the Land Transportation Office in Baguio City, bearing
her photograph and signature, known to me as the same person who
personally signed the foregoing instrument before me and avowed
under penalty of law to the whole truth of the contents of said
instrument.

Doc. No. 10
Page No. 20
Book No. 1
Series of 2017

Atty. Princess Karina M. Marquez, RMT

Notary Public
Commission Serial No. 123456789
Until December 31, 2017
PTR No. 3202017; January 8, 2017; Baguio City
Roll No. 55701
IBP Lifetime Roll No. 987654321;Baguio City
MCLE Compliance Cert. No. 654987321
304 Porta Vaga Bldg., Baguio City

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