Republic of the Philippines )

Gubat, Sorsogon ) s.s.

JOINT AFFIDAVIT FOR LATE REGISTRATION OF BIRTH

We, JAYSON G. DOLUNTAP and ALANES JANE FURAQUE, of legal

ages, Filipino citizens, and residents of Macabari, Barcelona, Sorsogon, after
being duly sworn according to law do hereby depose and say:

1. That we personally know EJAY ENTERIA SAMONTE;

2. That he was born to parents Arjay Viñas Samonte and Jessica Evasco
Enteria on November 28, 2020 at Salvador R. Encinas District
Hospital, Gubat, Sorsogon;

3. That the birth of EJAY ENTERIA SAMONTE was not registered at

the Office of the Local Civil Registrar, Gubat, Sorsogon or elsewhere
due to negligence;

4. That we know these facts because we are close and intimate family
friends, neighbors, and acquaintances;

5. That we execute this affidavit to establish the truth of the foregoing

facts as a requirement to support the delayed registration of birth of
EJAY ENTERIA SAMONTE; and for whatever legal intents and
purposes this may serve.

IN WITNESS WHEREOF, we have hereunto set our hand this 15 th day of

February, 2021, at Gubat, Sorsogon Philippines.

JASON G. DOLUNTAP ALANES JANE FURAQUE

Affiant Affiant
VIN-6202-0018B-B2086JGD10003-6 SK Kagawad I.D.
Issued by COMELEC, Barcelona, Sor. Issued by LGU-Barcelona, Sor.

SUBSCRIBED AND SWORN to before me this 15th day of February,

2021,
at Gubat, Sorsogon Philippines.

RV-GUB-2021-02- ____________NJ