Republic of the Philippines)

Province of Davao del Sur ) SS

City of Davao )

AFFIDAVIT

I, JUDITH ALBERT MATARLO, Filipino citizen, of legal age, married to Ramon Soto,
and a resident of San Benito,Lipa city,Batangas after having been duly sworn in accordance
with law, hereby depose and say:

1. That I was married to Ramon Soto on April 05,1977;

2. That out of our wedlock, a child was born in the person of Moniera Rodette M. Soto on
October 17,1977;

3. That sometime in 1978, a separation between me and my husband Ramon Soto took place
due to some unresolved differences,

4. That since 1978 until today,there has been no communication between me and
RamonSotto; neither has there been any financial support accorded to Moniera Rodette

5. 5.That for convenience in acquiring a job abroad , I adopted and used the family name of
my friend Romy Dinglasan, hence I had been using the family name DINGLASAN until
the time that I enrolled myself to the Social Security System;

6. That that I was and am never married to Romy Dinglasan;

7. That I executed this affidavit to inform the SSS authorities that I remained as JUDITH
MATARLO SOTO and to request the same authorities to change my Name in my SSS
records from JUDITH MATARLO DINGLASAN to JUDITH MATARLO SOTO

Further Affiant sayeth none.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 19th day of January
2011 in Davao City, Philippines.

JUDITH MATARLO SOTO

Affiant

SUBSCRIBED AND SWORN before me this 19 th day of January 2011 by Judith

Matarlo Soto who exhibited to me her CTC No.09526692, issued on January 18,2011 at
Davao City, Philippines.
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