Republic of the Philippines)

Province of Rizal )
City of Antipolo ) S.S.
x------------------------------------------x

AFFIDAVIT OF COHABITATION
I, JOVER ALMOGIL BARTOLAY, of legal age, Filipino, single and a
resident of Sito Tumana Brgy. Cupang, Antipolo City, after having been duly sworn to
in accordance with law, depose and state that:

1. I and my common law wife had been cohabiting with each other for
the past six (6) years.
2. Unfortunately, our coverture is not blessed of any offspring;
3. We are fully aware of our living together without the benefits of
marriage and knows our responsibilities and obligations towards each
other;
4. I am executing this affidavit to attest the truth of the foregoing facts.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of

November 2016 at Antipolo City, Rizal.

JOVER ALMOGIL BARTOLAY

Affiant

SUBSCRIBED AND SWORN TO before me this 10th day of November 2016 at

Antipolo City, Rizal Philippines, affiant exhibited to me his SSS I.D. with No. 33-
2507199-9 issued by the SSS- Antipolo.

NOTARY PUBLIC

Doc. No. __________;

Page No. __________;
Book No. __________;
Series of 2016.