AFFIDAVIT

As required by Article 34 of the Family Code

REPUBLIC OF THE PHILIPPINES

City of Iligan )s.s

We _____________________________________ and ________________________

both of age residents of ____________________________ after having been duly sworn to in
accordance with law hereby depose and say:

That we have been living together as husband and wife for at least five years without the
benefit of a lawful marriage, and it is now our desire to marry each other.

IN WITNESS WHEREOF, we have hereunto set hands this ___ day of ____ 2021 at
___________________, Philippines.

_________________________ ________________________
Male Female

SUBSCRIBED AND SWORN to before me this ___ day of ___ 2021 at __________ ,
Philippines.

Doc. No. _____________;

Page No. _____________,
Book No. ______________
Series of 2021.

_________________________________________ having been duly authorized to solemnize

marriage in according with law, do hereby state that I have taken steps to ascertain the age and
other qualification of the contracting party above named, and that I have found no legal
impediment to their marriage.

______________________________
(Office solemnizing marriage)

SUBSCRIBED AND SWORN to before me this ___ day of ___ 2021 at __________ ,
Philippines.

Doc. No. _____________;

Page No. _____________;
Book No. _____________;
Series of 2021.