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Affidavit of Guardianship

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Republic of the Philippines )

Province of__________ ) S.s


City of ___________ )

AFFIDAVIT OF GUARDIANSHIP

I, ________________________, of legal age, Filipino, married and a resident


of ___________________________ after being duly sworn to in accordance with
law, depose and state that:

1. I am the ___________________ and guardian of the minor,


____________________ who was born on ___________________ at
___________________________________;

2. The above-mentioned minor is under my care and custody since his


birth because her mother, ______________________ is suffering from
Epilepsy, a neurological condition that causes unprovoked, recurrent
seizures and his father, _________________________ has already
abandoned the said child;

3. I am not imbecile, insane, vagrant, or vicious person or a habitual


drunkard or a habitual criminal, and have not abandoned, neglected
or refused to support the said minor or cause him to commit offenses
against the law;

4. I am executing this affidavit to confirm and affirm the foregoing facts


and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this


___________________________ at _________________________, Philippines.

___________________________________
Affiant

SUBSCRIBED AND SWORN to before me this ______________________ at


_________________________________ .

Notary Public

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