Professional Documents
Culture Documents
2. That we declare and certify that he/she was born in the town of _____________________, in the
province of _______________________, in the Philippines, on ____________________________.
Date of Birth
3. That he/she has been using the said birth date in all his/her pertinent documents and transactions
since childhood;
4. That we are not related by affinity or consanguinity to _________________________________; and
Name of Person
5. That we are executing this affidavit to attest to the truth of the foregoing statement and for whatever
legal purpose it may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this _____ day of ____________, 20___, in
______________________________________________.
AFFIANT AFFIANT
SSS/GSIS ID No. or License No. or SSS/GSIS ID No. or License No. or
Passport No.: Passport No.:
Date of Issue/Expiry or Date of Issue/Expiry or
Place of Issue: Place of Issue:
ADMINISTERING OFFICER