REPUBLIC OF THE PHILIPPINES

MAKATI CITY, METRO MANILA ) S.S.

AFFIDAVIT TO USE THE SURENAME OF THE FATHER

I, LAWRENCE A. REYES, of legal age, Filipino, with postal and

residence address at ___________, after having been duly sworn to in
accordance with law hereby depose and say: THAT-

1. I am the biological father of of Christoph S. Reyes

(“Christoph” for brevity);

2. The biological mother of my child is Magdalena C. Santos;

3. My child Christoph was born on ______ at ________;

4. I Lawrence A. Reyes, being the father of Christopher

hereby acknowledge and recognize him as my child and legal
heir;

5. I am allowing my child Christopher to use my surname,

REYES to be his surname and shall be known as
CHRISTOPH S. REYES.

6. I am executing this affidavit to attest to the truth and veracity

of the foregoing facts and for whatever legal intents and purpose
it may serve, in compliance with the provision of Republic Act
No. 9255.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this ________ at Makati City, Metro Manila.

Conforme:

_____________________ _____________________
Magdalena C. Santos Lawrence A. Reyes
Mother Affiant/Father

SUBSCRIBED AND SWORN to before me, this _______, by

Lawrence A. Reyes who exhibited to me his Passport I.D No. ______
issued at Makati City, Philippines on 04 April 2018.
 NOTARY PUBLIC

Doc. No. ____;

Page No. ____;
Book No.____;
Series of 2019.