REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) S.S.

CITY OF SAN FERNANDO )

AFFIDAVIT
I, CAYETANO PALAROAN MACATO, of legal age, married, Filipino citizen, resident of
Brgy. Sto. Rosario, San Juan, La Union, after having been duly sworn to in accordance with law
hereby depose and state that:

I am an applicant for a certification for the circumstances of my true birth before the Office of
the Local Civil Registrar of San Juan, La Union;

The Office of the Civil Registrar of San Juan, La Union has no record of my birth considering
that records of births in their office during the period 1918 to 1944 were all destroyed by World
War II, hence they cannot issue the undersigned a true transcription from their Register of Births
or true copy of the Certificate of Live Birth of the undersigned;

When I applied for the first time a copy of my birth certificate before the Office of the Civil
Registrar of San Juan, La Union, they cannot provide me of the same due to the foregoing reason;

In my first application on February 2, 2004, I alleged/indicated an erroneous date for my birth

stating that I was born on August 7, 1918 based on my own recollection instead on August 7, 1921
and considering I was already 83 years old then, my memory could not have been reliable as
before;

Subsequent verification on the matter on March 23, 2017 especially with reference to my
Marriage Contract (attached as ANNEX “A”) and the certification issued by the Office of the
Civil Registrar of San Juan, La Union relative to the circumstances of marriage with Eustaquia
Quejado (attached as ANNEX “B”) would indicate/appear that I was actually born on August 7,
1921;

In view of the foregoing, I am now requesting anew the Office of the Civil Registrar of San
Juan, La Union for a new certification of the circumstances of my true birth and to correct the
erroneous entry indicating that I was born on August 7, 1918 which was an honest mistake when I
applied for the first time to August 7, 1921; and

I am executing this affidavit to attest to its truthfulness and veracity in support to my

application for the issuance of a certification that I was actually born on August 7, 1921 and to
correct the previous certification issued to the undersigned stating thereat that I was born on
August 7, 1918 where in truth and in fact, I was actually born on August 7, 1921.

IN WITNESS WHEREOF, I have hereunto affixed my thumb mark this ___ day of
_____________________, 2020 at San Juan, La Union, Philippines.

CAYETANO PALAROAN MACATO

Affiant

SUBSCRIBED AND SWORN to before me this 13th day of February 2020 at San Juan, La
Union, Philippines, affiant exhibiting to me his __________________________.

___________________________
Administering Officer