Affidavit of Delayed Registration of Birth
Affidavit of Delayed Registration of Birth
Affidavit of Delayed Registration of Birth
Province of Tarlac ) S. S.
Municipality of Capas )
I, JESSICA DELA VEGA REYES, of legal age, Filipino and a resident of Brgy. Cristo
Rey, Capas, Tarlac, after having being duly sworn to in accordance with the law, hereby deposes
and states THAT:
1. I am the biological mother of LOVELY JOY REYES CASTRO who was born on 09
October 2012 in Capas, Tarlac and her biological father being ROGIE MARK LUCERO
CASTRO;
2. The father of my child and I are not married at the time she was born, and as such, my child
is considered an illegitimate child;
3. When I gave birth to my daughter LOVELY JOY REYES CASTRO, it was attended by
a traditional midwife, at our house;
4. By reason of such fact, I forgot to cause the registration of the birth of my above-named
child;
5. Consequently, the fact of the birth of my above-named child has not yet been registered
with the Civil Registry of Capas, Tarlac, where she was born;
6. I have executed this affidavit for the purpose of causing the delayed registration of birth of
LOVELY JOY REYES CASTRO;
7. I attest to the truthfulness and veracity of the foregoing statements being my own and
personal knowledge and belief.
IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of February 2017 in
Capas, Tarlac, Philippines.
______________________________
JESSICA DELA VEGA REYES
SUBSCRIBED AND SWORN TO before me this 23rd day of February 2017 in Capas,
Tarlac, Philippines, the affiant JESSICA DELA VEGA REYES having satisfactorily established
her identity to me by exhibiting her Voters ID with ID No. 6904-0160B-J1091JDR20000 bearing
her picture and signature, and that she is the same person who appeared and signed the foregoing
instrument in my presence and within my jurisdiction, and who avowed to the truth of its content
under the penalty of law.