REPUBLIC OF THE PHILIPPINES)

_____________________ ) S.S.

JOINT AFFIDAVIT OF TWO DISINTERESTED WITNESSES

WE, ____________________________ and ________________________, of legal ages,

Filipinos, and a resident of ______________________________________________, and
______________________________________________, respectively, duly sworn to in
accordance with law depose and say:

1. That both of us are not related in any blood to

______________________________;

2. That he is the biological son/daughter of ______________________________

and ______________________________ who got married on
________________________ in ______________________________________
and who died on ______________ and _______________, respectively;

3. That we are fully aware that he/she was born on ________________________ at

_________________;

4. That he is now _______________ (___) years old;

5. That however, he has no record of Live Birth at Local Civil Registrar of

__________________and National Statistics Office;

6. That we are executing this affidavit to attest the truth of the foregoing facts and
for the purpose of the delayed registration of birth of
___________________________________ and for whatever legal purposes it
may serve.

AFFIANTS FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, we have hereunto set our hands and affix our signatures this
____________________________, in the ________________.

________________________________ _________________________________
Affiant Affiant
_____________ID No. _____________ _____________ID No. _____________

SUBSCRIBED AND SWORN to before me this ________________________on

______________________. Affiants exhibited to me their Competent Evidence of Identity
abovementioned.