REPUBLIC OF THE PHILIPPINES )

Province of Nueva Ecija ) S.S.

Science City of Munoz )

AFFIDAVIT OF FACTS OF BIRTH

I, JOCELYN VILLA SORIANO, of legal age, married, Filipino,

presently residing at Barangay Magtanggol, Science City of Muñoz, Nueva
Ecija, after having been sworn to in accordance with law, hereby depose and
state, THAT:

1. I am the mother of CRYSTHEL VILLA SORIANO who

was born on October 03, 2015 in Barangay Magtanggol,
Science City of Muñoz, Nueva Ecija.

2. I failed to register her birth, hence, my desire to cause the

late registration of it with the Local Civil Registrar of the
Science City of Muñoz, Nueva Ecija, the place where she
was born.

3. I have executed this affidavit to attest to the truthfulness of

the foregoing facts, for the late registration of her birth or
any remedy that may be available for me regarding her birth
certificate or for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

December 01, 2020 2020 at Science City of Munoz, Nueva Ecija.

JOCELYN VILLA SORIANO

Affiant
SSS Id No. 33-2631813-0

SUBSBRIBED and SWORN to before me this December 01, 2020 at

Science City of Muñoz, Nueva Ecija and I hereby certify that the affiant has
read the contents of her affidavit and understands the same.

Doc. No.: 392;

Page No.: 80;
Book No.: VIII;
Series of 2020.