Republic of the Philippines)

) S.S

AFFIDAVIT

I, ______________, Filipino, of legal age, with address at ____________________, having

been duly sworn in accordance with law, hereby depose and states:

1. I have personally known the person of ________________ for a long period of time;

2. That I know for a fact that the person by the name of "_____________________"
appearing in some documents and records or specifically in her Driver’s License
and the name "_______________________" as appearing in her Birth Certificate an in
____________________ refer to one and the same person;

3. That I know for a fact that __________________ changed her first name to
______________________ as a consequence of change in her citizenship;

4. I am not in any way related to ___________________________ within the fourth civil

degree either by consanguinity or affinity, nor do I have any pecuniary interest in this
matter whatsoever;

5. As such, I execute this Affidavit and attest to the truth of the foregoing facts and for
whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, we have hereunto set

our hands this _________________ in _______________, Philippines.

_______
Affiant

SUBCRIBED AND SWORN TO before me this ______________ in

_________________, Philippines, affiants exhibiting to me her _______________________.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2018.