Form No. 9. Affidavit of Guardianship

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FORM NO. 9.

AFFIDAVIT OF GUARDIANSHIP

Affidavit of Guardianship

REPUBLIC OF THE PHILIPPINES)


CITY OF BAGUIO ) S.S.

I, MARIAN P. RIVERA, of legal age, widow, Filipino


citizen, and presently residing at #56 Happy Homes, Campo
Sioco, Baguio City, Philippines, under oath, state:

1. That I am the grandmother of JEAN P. RIVERA who


was born on Dec. 16, 1990 to ANDY P. RIVERA and
LESLIE P. RIVERA at Kibungan, Benguet Province,
Philippines;

2. That JEAN P. RIVERA is a transferee student of Pines


City National High School as 3rd Year High School
Level;

3. That one of the requirements in support of his


transfer is the
submissionof the Certificate of Live Birth issued by th
e National Statistics Office (NSO);

4. That since birth until present, the parents of JEAN P.


RIVERA leave the care and custody of their
daughter to me, the father being my son;

5. That for almost sixteen (16) years, I have been the g


uardian of JEAN P. RIVERA;

6. That I am executing this Affidavit of Guardianship in s


upport of theapplication of Certificate of Live Birth of
JEAN P. RIVERA and to declare the truth of the
foregoing facts and for whatever legal purpose it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand


this 20th day of January, 2017 at Baguio City, Philippines.

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MARIAN
P. RIVERA

(Signature of Affiant)

SUBCRIBED and sworn to before me, this 20th day of


January 2017, in the City of Baguio, Philippines, by Marian P.
Rivera exhibiting to me her
Senior Citizen Identification Card No. 4675899 Issued
on: May 8, 2014; Issued at Baguio City, Philippines.

Doc. No. _9___;


ATTY. DENVER A.
Page No. _6___;
GAMLOSEN
Book No. __2__;
Series of NOTARY
2017 . NOTARY PUBLIC
Commission Serial No. 105
PUBLIC
Until December 31, 2017
ROLL NO. Roll No. 10987
P.T.R. No. 0007, 1/4/2017,
BAGUIO CITY,
Baguio.
PHILIPPINES
IBP No. 0003, 1/9/2017,
Baguio.
MCLE Compliance No. 1234

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