Republic of the Philippines )
) S.S
AFFIDAVIT OF CITIZENSHIP AND RESIDENCY
I, , of legal age, Filipino, , and a resident of , after having been duly sworn to in accordance with law, hereby depose and say, THAT:
IN WITNESS HEREOF, I have hereunto signed my name below this in , Philippines.
Affiant
Government Issued ID Number:
SUBSCRIBED AND SWORN TO BEFORE ME, this
in
, Philippines.
Doc. No. _____
Page No. _____
Book No. _____
Series of 2025