REPUBLIC OF THE PHILIPPINES )

PROVINCE OF NORTHERN SAMAR ) S.S.

MUNICIPALITY OF CATARMAN )

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

RE: ONE AND THE SAME PERSON

We, ______________, and ____________, both of legal ages, Filipinos,

married and both are residents of __________, after having been sworn in
accordance with the law herby depose and state that:

1. We personally know __________, who is our long time neighbor

and acquaintance at ________, and the fact of his birth is
registered at the Local Civil Registrar of ________;

2. We know for a fact that the person by the name of “_______” as

appearing in some documents or specifically in his Certificate of
Live Birth and identification cards, refers to one and the same
person and that his true and correct name is __________;

3. We are not in any way related to any of the foregoing person

within the fourth civil degree either by consanguinity or affinity,
nor do we have any pecuniary interest in this matter
whatsoever;

4. To remove confusion as to the two names, we hereby declare

that the name _________ and ________ refer to one and the same
person whose registered name is ______;

5. We are executing this affidavit to attest to the truthfulness of

the foregoing statements and to establish the real identity of
_______ and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of

February 2018 at Siniloan, Laguna, Philippines.

S S
Affiant Affiant
ID. NO _____ I.D. No _____

SUBSCRIBED AND SWORN to before me, this February ___, 2018, by

the Affiant whom I have identified through competent evidence of identity and
who exhibited his Community Tax Certificate No. _____ issued at ___ on
February 06, 2018.

NOTARY PUBLIC

Doc. No. ____

Page No. ____
Book No. ____
Series of _____