REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF BIRTH BY TWO DISINTERESTED PERSONS

WE, JONATHAN B. and FLORIDA Tboth Filipinos, of legal ages, both married, and presently
residing at 55C Burgundy Lane, Rainbow Hills Subdivision, Fairview, Baguio City and at #2 Rd., Irisan,
Baguio City, respectively, both after having been duly sworn in accordance with law, do hereby depose
and say:

1. That we personally know MIRASOL of Guisad, Baguio City, being acquaintance for a long period
of time;

2. That she is a PAG-IBIG Fund member with an application for Provident Benefits with the Fund;

3. That the said application is required to be accompanied by a copy of the applicant’s birth
certificate, however, no record can be obtained, as shown by the attached Certification of Non-
Availability of Birth Record from the National Statistics Office (NSO);

4. That we certify that she was born at Baguio General Hospital, Baguio City Philippines, on the 14 th
day of February in the year 1977 ;

5. That she has been using the said birth date in all her documents and transactions, including her
education and employment records;

6. That we are not related by affinity or consanguinity to the above mentioned person; and

7. That we are executing this affidavit to attest to the truth of the foregoing facts for record and
references purposes.

IN WITNESS WHEREOF, we have hereunto set our hands this 22nd day of November 2012, at
Baguio City, Philippines.

___________________ ____________________
JONATHAN B. FLORIDA T.
Affiant Affiant
CTC No. 28738278 CTC No. 39824983
Issued on January 17, 2012 Issued on March 15, 2012
Issued at Baguio City Issued at Baguio City

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 22nd day of
November 2012, by __________ who have satisfactorily proven their identities through:

JONATHAN B. =, with Passport No. BB5593189, valid until February 14, 2016.
FLORIDA T. with Passport No. SS8533100, valid until April 18, 2013.

who personally know the principal, to be the same persons who executed and personally signed the
foregoing affidavit before me and acknowledged that they executed the same.