Republic of the Philippines )

Tacloban City, Leyte ) s.s

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE,___________________________and______________________________,
both of legal ages, Filipinos, single/married to __________________________ and
___________________________, respectively and residents of
______________________________________ after having been sworn in accordance
with the law hereby depose and state that;

1. We personally know _____________________________, daughter of

_____________________________ and __________________________ and
was born on ___________________, is our long time neighbor and acquaintance
at Brgy. Pago, Tanauan, Leyte, and the fact of her birth has not been duly
registered with the Local Civil Registry of Tanauan, Leyte;

2. We know for a fact that the person by the name of __________________ whose
birth place is at Eastern Visayas Regional Medical Center, as appearing in her
Certificate of Live Birth and the name __________________ whose as appearing
in her Baptismal Certificate, refer to one and the same person;

3. We are not in any way related to any of the foregoing person within the fourth
degree either by affinity of consanguinity, nor do we have any pecuniary interest
in this matter whatsoever;

4. To clarify and confirm the identity of _________________________, we hereby

declare that the name ____________________ with birthplace at
___________________ refer to the same person;

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 WITNES WHEREOF, we have hereunto set our hands this ___ day of June, 2018 at
Tacloban City, Leyte, Philippines.

___________________________________ ___________________________________
AFFIANT AFFIANT
ID:________issued on :___ at :______ ID:________issued on :___ at :______
ID:________issued on :___ at :______ ID:________issued on :___ at :______

SUBSCRIBED AND SWORN TO before me this ____ day of May , 2018 at Tacloban
City, Leyte,Philippines.

Notary Public

Doc No.:
Page No.:
Book No.:
Series of 2018