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Affidavit For Delayed Registration of Birth

This affidavit is for the delayed registration of a certificate of live birth. It states that the applicant was born out of wedlock in Manila City and that a court decision later allowed them to change their surname. The applicant recognizes their attorney-in-fact to represent them to annotate the court decision and certificate of finality on their birth certificate. The affidavit is signed to attest to the truth of these facts.

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172 views1 page

Affidavit For Delayed Registration of Birth

This affidavit is for the delayed registration of a certificate of live birth. It states that the applicant was born out of wedlock in Manila City and that a court decision later allowed them to change their surname. The applicant recognizes their attorney-in-fact to represent them to annotate the court decision and certificate of finality on their birth certificate. The affidavit is signed to attest to the truth of these facts.

Uploaded by

eliiiiiii
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines )

) S.S.

AFFIDAVIT FOR DELAYED REGISTRATION OF BIRTH

I, ______________________, of legal age, Filipino citizen, and with residence


address at ______________________, after being duly sworn to in accordance with
law, hereby depose and state that:

1. I am the applicant for the delayed registration of my Certificate of Live Birth under
Civil Registry No. __________________of the Local Civil Registry of Manila City;

2. I was born on ______________________ out of wedlock to


______________________ and ______________________ at the City of
Manila;

3. On _________, the Regional Trial Court, Branch ___ of the City of Manila
promulgated its Decision allowing me to use “_______” as my surname thus my
full name is to change from “_________” to “_________”;

4. Consequently on February 18, 2021, a Certificate of Finality was issued stating


that the aforesaid Decision has become final and executory.

5. I hereby recognize Mr. _________as my Attorney-in-Fact pursuant to the Special


Power of Attorney that I executed on June 16, 2022, and authorize him to
transact on my behalf before the Local Civil Registrar of Manila and the
Philippine Statistics Authority to cause the annotation of the above Decision and
the Certificate of Finality on my Certificate of Live Birth.

6. I am executing this Affidavit to attest to the truth of the foregoing facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this ____ day of


______________________ at ___________________.

_________
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of ____________, in


__________________, affiant exhibiting to me her valid Government Issued ID which is
a _________, issued on 11/22/2016, containing her photograph and signature.

Doc No. _____;


Page No. _____; NOTARY PUBLIC
Book No. _____;
Series of 2022.

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