Republic of the Philippines )

Province of Bulacan )
Municipality of San Ildefonso ) S. S.

JOINT AFFIDAVIT
We, and , both Filipinos, of
legal age, and residents of Barangay , San Ildefonso, Bulacan,
Philippines, having been duly sworn in accordance with law, hereby depose and state:

That, we both personally know the person of because we

had lived in the same locality for a long time, and he had been a close family friend;

That, said has registered with Social Security Service

(SSS) as member;

That, upon inquiry with the office of the SSS, it was then discovered that there
has been two (2) registrations under the name of ;

However, there has been a discrepancy with regard to the mothers name, one
with Naty de Leon and the other is Natividad de Leon;

That, the name of with mothers name as Naty de Leon

and with mothers name as Natividad de Leon refers to one and
the same person;

That, such discrepancy was a simple inadvertence, done in good faith and not
intended to defraud the public;

As such, we execute this Joint Affidavit to attest to the truth of the foregoing facts
and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this 5th day of May
2017, in San Ildefonso, Bulacan, Philippines.

Affiant Affiant
ID No. ID No.

SUBSCRIBED AND SWORN to before me this 5 th day of May, 2017, here in

Bulacan, Philippines.

Doc. No. : _____;

Page No. : _____;
Book No. : X ;
Series of 2017.