Republic of the Philippines)

Province of Agusan del Sur) S. S.

City of ______ )
X - - - - - - - - - - - - - - - - - - /

AFFIDAVIT OF COHABITATION

That we, ____________ and _____________ both of legal

age, Filipino citizens and presently residing at
__________ ,Agusan del Sur, Philippines, after having been
duly sworn to oath in accordance with law, do hereby depose
and say:

That we are the same persons executing this affidavit;

That we are living together as common-law husband and

wife since year 2007 without the benefits of marriage;

That we wanted to enter into marriage legally pursuant

to the provision of Article 34 of the New Family Code of the
Philippines;

That we are executing this affidavit to attest to the

truthfulness of the foregoing statements; and

AFFIANTS SAYETH NONE.

IN WITNESS WHEREOF, we have hereunto affixed our

signatures this 21st day of March _______ at Bayugan City,
Philippines.

_____________________ __________________
(Affiant) (Affiant)

SUBSCRIBED AND SWORN TO BEFORE ME this 21st day of

MARCH, __________ at Bayugan, Agusan del Sur, Philippines.