Affidavit of Abandonment

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Republic of the Philippines )

Tuguegarao City, Cagayan )

AFFIDAVIT OF ABANDONMENT

I, JACINTO Q. DACULUG, of legal, married, Filipino and an Overseas Fiilipino


Worker in Dubai, United Arab Emirates currently on vacation in the Philippines,
after having been sworn to in accordance with law, depose and state, that:

1. I had a common-law relationship with Imelda Quinagoran in 2005;

2. Out of the relationship was born Yuan Vincent Daculug;

3. My common-law spouse abandoned me and my child in 2006 and since that


time she has not communicated with us nor extended any financial support;

4. I am executing this affidavit to attest to the truth of the foregoing facts,


particularly, the abandonment of my spouse; and in compliance with the
requirements for the issuance of a Philippine passport for my son Yuan Vincent
Daculug and for any other legal purpose it may serve.

In witness whereof, I hereunto affix my signature this 2 nd day of January 2017 in


Tuguegarao City, Cagayan.

JACINTO Q. DACULUG
Affiant
Philippine Passport No. EC3862602

Subscribed and sworn to before me at the place and date first above-written,
affiant showing to me the government-issued identification card indicated below
his name as valid proof of his identity.
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of 2017.

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