Affidavit of Abandonment by Spouse

                       AFFIDAVIT OF ABANDONMENT BY SPOUSE



I, _______________________________, Filipino, of legal age, married, presently residing at

_________________________________________________________________________,

after having been duly sworn to in accordance with law, hereby depose and state the following:

1. That I am married to ______________________ Filipino and of legal age.  We were married on

     ________________________________ in ________________________________________.

2. That out of this marriage was born our child/children:

     ___________________________________________

     ___________________________________________

     ___________________________________________

3.  That my spouse, _____________________________, abandoned me and my child/children on
   
      ___________________________________, and since this date, has not communicated with us

       and has not extended any financial support;

4.  That I am executing this affidavit to attest to the truth of the foregoing facts, particularly,
      the abandonment of my spouse, for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________________ in the City of
 ________________, ______________.
 

                                                                                                  AFFIANT                                                                                                                              
                                                                               ________________________________
                              
                                                                                 SSS ID No.  ___________________
                                                                                 or GSIS No. or Passport No. or Driver's License No.
                                                                                 or PRC License No.  or Cedula or Community Tax Cert. No.
                                                                                 and Date Issued and Expiry Date, if applicable



SUBSCRIBED AND SWORN to before me this_______ day of__________, by above affiant who has satisfactorily proven to me his/her identity through his/her  _____  (ID), that he/she is the same person who personally signed before me the foregoing affidavit and acknowledged that he/she executed the same.


Doc. No.  _______
Page No.  _______
Book No. _______
Series of   _______
                                                                                          NOTARY PUBLIC