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REPUBLIC OF THE PHILIPPINES

CITY OF GENERAL SANTOS S.S

JOINT-AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, AJILIA N. BITAISAR and JOSE GINO Z. SABERON, both of legal ages, Filipino, married, and
with residence at #19 Tieza St., Brgy. Dadiangas North, General Santos City and Purok 7 New Society,
respectively, after being sworn to in accordance with law do hereby depose and say;

That we are the friends and acquaintances of the LOILLA VANESSA O. LUMPAN, for twenty (20)
years;

That being the friends and neighbors hereof, we knew that her father BREZELIO JORDAN
LUMPAN, SR. died last May 17, 2011 at General Santos City as evidenced by the Certificate of Death
duly issued by the Local Civil Registrar, General Santos City;

That the true and correct name of the late BREZELIO JORDAN LUMPAN, SR. parents are
CAYETANO LUMPAN and JULIANA LUMPAN, as evidenced by his Certificate of Live Birth duly issued by
the National Statistics Office;

That there exists discrepancy in the name of the late BREZELIO JORDAN LUMPAN, SR. parents
in his records before the Office of the Social Security System; that said discrepancy is to the name of his
parents as “ANTHONIO and ANITA per E1 form under SSS Account No. 09-12750150 which is
erroneously far different from his new existing SSS account No. 09-1079772-0 bearing the true name of
his parents as CAYETANO LUMPAN and JULIANA LUMPAN;

That the former SSS Account bearing No. 09-12750150 was already cancelled for the reason
that it bears error in the name of the late BREZELIO JORDAN LUMPAN, SR. parents;

That the name “ANTHONIO” and “ANITA” were used by the late BREZELIO JORDAN LUMPAN,
SR. in his prior E1 form bearing SSS No. 09-12750150 representing his parents because he was
uncertain to write the name of his biological parents in the said E1 form since during the said application
his parents were already dead;

That “ANTHONIO” is a godfather and a longtime friend of BREZELIO JORDAN LUMPAN, SR.
while “ANITA” is a mother-in-law of BREZELIO JORDAN LUMPAN, SR.;

That the use “ANTHONIO” and “ANITA” is in good faith and without intention to violate any law or
hide any crimes thereof;

That the true and correct name of BREZELIO JORDAN LUMPAN, SR. parents are CAYETANO
LUMPAN and JULIANA LUMPAN, as evidenced by his Certificate of Live Birth duly issued by the
National Statistics Office;

That we are executing this affidavit to attest the truthfulness and veracity of the foregoing
statements.

IN WITNESS WHEREOF, We have hereunto set our hands this 24th day of January, 2014, in the
City of General Santos, Philippines.

JOSE GINO Z. SABERON AJILIA N. BITAISAR


Affiant Affiant
TIN: 428-206-661 Postal ID No. 9823152

SUBSCRIBED AND SWORN to before me, this 24th day of January, 2014, at General Santos City,
Philippines, affiants exhibiting to me their ID Nos. written below their names.

ATTY. JOSE EDMAR J. YUMANG


NOTARY PUBLIC, GSC
DECEMBER 31, 2015
ROLL NO. 57439
Doc. No: 281; IBP NO. 942389
Page No. 57 ; TIN NO. 161-923-968
Book No. XXXII ; PTR NO. 00000GS-5301916
Series of 2014. MCLE COMP. NO. IV-0015346
(4th Compliance period)

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