REPUBLIC OF THE PHILIPPINES)

CITY/MUN. OF ____________ ) S.S.

x------------------------------------x

JOINT AFFIDAVIT OF COHABITATION

WE, ___________________ and _________________, both

of legal age, Filipino, single (living together) and residents of
_______________________________, after having been duly sworn to
in accordance with law, depose and state THAT:

1. We have been living together as husband and wife under the same roof,
continuously and without any interruption, since _________ or a period
of more than five (5) years;

2. During our cohabitation and even until the present, we remain both of
single status and, hence, there exists no legal impediment for us to
marry each other;

3. We were blessed with one son named ___________________ who

was born on _________________ in _____________________;

4. We are executing this affidavit to attest to the foregoing facts and for
the purposes of contracting marriage without the need of securing
the marriage license pursuant to the provisions of Article 34 of the
Family Code of the Philippines.

IN WITNESS WHEREOF, we have hereunto set our hands

this ___________________in _______________, Philippines.

__________________ ____________________
Affiant Affiant
SSS ID No. _____________ GSIS ID No. _____________

SUBCRIBED AND SWORN TO before me

this ___________________ in _________________, Philippines,
affiants exhibiting to me their valid proofs of identification.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2013.