Republic of the Philippines )

Province of Isabela ) s.s.

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

AFFIDAVIT OF TWO DISINTERESTED PERSON

We,_________________ and _____________________both of legal

ages, Filipino citizens, and residents of Brgy. _________, ___________, Isabela, after
having been duly sworn to in accordance with law do hereby depose and state:

1. That we are the same person executing this affidavit;

2. That we personally know EPIFANIA BAUTISTA;

3. That we know for a fact EPIFANIA BAUTISTA for a long period of time
because she is our long time family friend and neighbor;

4. That lately we have discovered that her name was erroneously recorded as
MAGDALENA BAUTISTA in the Certificate of Live Birth issued by both
Philippine Statistics Office (PSA) and Office of the Local Civil Registrar instead
of EPIFANIA BAUTISTA, which he used in all his school records and other
documents, which she normally used as her name;

5. That the name MAGDALENA BAUTISTA which was entered in the herein
attached Certificate of Live Birth and the name EPIFANIA BAUTISTA that
she used in all his school records and other documents, refers to one and the
same person;

6. That we are executing this affidavit to attest to the truth of the foregoing and
and for whatever lawful purpose it may serve.

__________________ ____________________
Affiant Affiant
ID NO. _______________ ID NO. _______________
ISSUED BY:___________ ISSUED BY:___________

SUBSCRIBED AND SWORN to before me this ____day of ____________,

2017 in_____________, Isabela.

Doc No. ____;

Page No. ____;
Book No. ____;
Series of 2017.