REPUBLIC OF THE PHILIPPINES)

Province of Camarines Sur) S.S.

City of Naga)
x-----------------------x

AFFIDAVIT TO USE THE SURNAME OF THE FATHER

I, RODERICK E. BRAVO, of legal age, Filipino, and presently residing

at Abella, Naga City after having been duly sworn to in accordance with law,
do hereby depose and say:

1. That I am the biological father of CEDRICK JAMES AGAWA;

2. That the biological mother of the child is JULIE C. AGAWA;

3. That our child was born on October 15, 2014 at Bicol Medical Center,
Naga City;

4. That I, RODERICK E. BRAVO being the father of CEDRICK JAMES

AGAWA, hereby acknowledged and recognized him as my child
and legal heir;

6. That I am allowing my child CEDRICK JAMES AGAWA to use

my surname BRAVO to be his surname in his Certificate of Live Birth
and such other documents as may be applicable; and

7. That I execute this affidavit to attest to the truth of the above facts and
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

____________ at Naga City, Philippines.

RODERICK E. BRAVO
Affiant

SUBSCRIBED AND SWORN to before me this _________ in the City of

Naga, Philippines, affiant exhibiting to me his competent evidence of identity
by way of his PhilHealth No: 05-050074193-4.

Doc No. : _____

Page No.: ______
Book No.: ______
Series of 2015 Notary Public