REPUBLIC OF THE PHILIPPINES )

PROVINCE OF ILOILO )
MUNICPALITY OF DUMANGAS )
X-----------------------X

JOINT AFFIDAVIT OF TWO

DISINTERESTED PERSONS

We, SAMPAGUITA DOFELIZ BASAL, 70 years old, and NEMIA DUPIT

JABONETA, 66 years old, Filipinos, and both residents of Brgy. Ermita, Dumangas,
Iloilo, Philippines, after having been duly sworn to in accordance with law do hereby
depose and state:

1. That we personally know the deceased BENNY GARDOSE DULLA who died on
February 11, 2021 at Brgy. Ermita, Dumangas, Iloilo, and who is the son of
Spouses Benigno Dionio Dulla and Trinidad Caserial Gardose;

2. That the true and correct middle name of the mother of the deceased is
CASERIAL which fact appears in the Certificate of Death of the deceased and in
his mother’s Certification of No Record of Birth issued by the PSA;

3. That however in the Certificate of Live Birth of the deceased BENNY GARDOSE
DULLA, his mother’s name appeared as TRINIDAD CASORIAL GARDOSE
wherein the latter’s middle name was erroneously recorded as CASORIAL
instead of CASERIAL;

4. That said discrepancy in the Certificate of Live Birth of the deceased Benny
Gardose Dulla as to his mother’s middle name could have been due to
inadvertence on the part of the informant who provided the information and
was made in good faith;

5. That in order to avoid confusion, we hereby attest to the truth that the names
TRINIDAD CASERIAL GARDOSE, whose middle name is CASERIAL, and
TRINIDAD CASORIAL GARDOSE, whose middle name is CASORIAL, refer to
one and the same person who is the mother of the deceased Benny Gardose
Dulla;

6. That we are not related in any way to the persons named herein and we execute
this affidavit without any monetary consideration;

7. That we are executing this affidavit to attest to the truth of the foregoing facts
stated hereto, to correct the said discrepancies in the Certificate of Live Birth of
Benny Gardose Dulla, and for whatever legal purpose this may serve best.

IN WITNESS WHEREOF, We have hereunto set my hand this ______________ in

the Municipality of Dumangas, Iloilo, Philippines.

SAMPAGUITA DOFELIZ BASAL NEMIA DUPIT JABONETA

Affiant Affiant
ID No. 5678 ID No. 8172
Issued by: OSCA Issued by: OSCA

SUBSCRIBED AND SWORN to before me this ____day of February 2022 at

Dumangas, Iloilo, Philippines, affiants having exhibited by me through their
competent evidence of identity as defined by the 2004 Rules of Notarial Practice
pursuant to Supreme Court En Banc A.M. No. 02-8-13-SC Resolution.