JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

I, _______________________________, Filipino citizen, of legal age, and with

residence address at ___________________________________________________,
and I, ________________________________, Filipino citizen, of legal age, and with
residence address at ________________________________________________,after
having duly sworn in accordance with law, hereby depose and state:

1. That we are acquaintances of Mr.___________________________________and

Mrs._________________________________ who are the parents of;

NAME DATE AND PLACE OF BIRTH

2. That we know the circumstances of the birth of the above-mentioned child as we

have known their parents for a long time now aside of the fact that we have always
been invited to attend their child’s birthday celebrations; and

3. That we are executing this affidavit not for any remuneration whatsoever but to
attest to the truth of the foregoing statements in connection with the registration of the
birth of the above-mentioned child with Philippine authorities.

FURTHER AFFIANTS SAYETH NAUGHT.

_______________________________ _______________________________
Affiant Affiant

Type of ID:_____________ Type of ID:_______________

ID Number:_____________ ID Number:_______________
Issued on:______________ Issued on:________________
Expiration:______________ Expiration:________________

SUBSCRIBED AND SWORN to before me, this ________ day of _______, 2012
at _____________.

NOTARY PUBLIC

Doc. No. ______________

Page ________________
Book ________________
Series of______________