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Ausf Dwayne Miranda Griego

Gladiz Miranda Griego filed an affidavit to use the surname of Dwayne Aisle G. Prado's father. She seeks to change her and her son's surname from Miranda to Prado on their birth certificates according to RA 9255. Her son Dwayne was born on February 15, 2017 in Laurel, Tanauan City, Batangas. She filed the affidavit with the City Registrar of Tanauan, Batangas to legally change their surnames.

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257 views1 page

Ausf Dwayne Miranda Griego

Gladiz Miranda Griego filed an affidavit to use the surname of Dwayne Aisle G. Prado's father. She seeks to change her and her son's surname from Miranda to Prado on their birth certificates according to RA 9255. Her son Dwayne was born on February 15, 2017 in Laurel, Tanauan City, Batangas. She filed the affidavit with the City Registrar of Tanauan, Batangas to legally change their surnames.

Uploaded by

RoseMantupar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Date:

Registry No.

REPUBLIC OF THE PHILIPPINES )


PROVINCE OF BATANGAS )
MUNICIPALITY OF STO. TOMAS ) S.S.

AFFIDAVIT TO USE THE SURNAME OF THE FATHER (AUSF)

I, GLADIZ MIRANDA GRIEGO, Filipino citizen, a resident of San Isidro Sur,


Sto. Tomas, Batangas, after having been duly sworn in accordance with law, do hereby
declare that:

1. I am seeking to use the surname PRADO in:

a) my Certificate of Live Birth/Report of Birth, pursuant to R.A. No. 9255.

b) the Certificate of Live Birth/Report of Birth of DWAYNE AISLE G.


PRADO , my child, pursuant to R.A. 9255.

2. He was born on FEBRUARY 15, 2017 at LAUREL, TANAUAN CITY


BATANGAS;

3. I am filing this affidavit at the City Registrar of Tanauan, Batangas in accordance


with R.A. 9255 and its Implementing Rules and Regulations;

4. I hereby certify that the statements made herein are true and correct to the best
of my knowledge and belief.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


November 23, 2018 at Sto. Tomas, Batangas.

GLADIZ MIRANDA GRIEGO


Affiant

SUBSCRIBED AND SWORN to before me this November 23, 2018 at Sto.


Tomas, Batangas.

ARTH JHUN A. MARASIGAN


NOTARY PUBLIC
Until December 31, 2019
Doc. No. _____; PTR No. 21635686 01.03.18 / Sto. Tomas, Batangas
Page No. _____; IBP Life No. 07648 / Roll No. 49621
Unit No. 1, Mt. View Subd. Mayapis Avenue
Book No. _____; Tanauan City, 4232
Series of 2018.

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