REPUBLIC OF THE PHILIPPINES)

CITY/MUN. OF ____________ ) S.S.

x------------------------------------x

JOINT AFFIDAVIT OF COHABITATION

WE, ___________________ and _________________, both of legal age, Filipino, single (living together) and residents of
_______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. We have been living together as husband and wife under the same roof, continuously and without any interruption, since
_________ or a period of more than five (5) years;

2. During our cohabitation and even until the present, we remain both of single status and, hence, there exists no legal impediment
for us to marry each other;

3. We were blessed with one son named ___________________ who was born on _________________ in
_____________________;

4. We are executing this affidavit to attest to the foregoing facts and for the purposes of contracting marriage without the need of
securing the marriage license pursuant to the provisions of Article 34 of the Family Code of the Philippines.

IN WITNESS WHEREOF, we have hereunto set our hands this ___________________ in _______________,
Philippines.

__________________ ____________________
Affiant Affiant
SSS ID No. _____________ GSIS ID No. _____________

SUBCRIBED AND SWORN TO before me this ___________________ in _________________, Philippines, affiants exhibiting
to me their valid proofs of identification.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2013.