Republic of the Philippines)

City of Cebu )S.S.

AFFIDAVIT FOR DELAYED REGISTRATION OF BIRTH

I, ANGELY ABAN BAGUIO, of legal age, married, and with residence and postal
address at Sitio Kalinao, Cabantan, Brgy. Luz, Cebu City, after having been duly sworn
to in accordance with law, do hereby depose and say:

1. That I am the applicant for the delayed registration of the birth of my daughter
ARIANNE MAE BAGUIO OBSID;

2. That she was born on May 26, 2012, at Cebu City;

3. That I delivered her in Cebu City Medical Center but I could no longer remember
the Doctor who attended her at birth;

4. That I am a Filipino Citizen;

5. That I am married to JORYL HABLA OBSID on June 12, 2014 at Mabolo

Catholic Church;

6. That the reason for the delay in registering my daughter’s birth was due to the
fact I was sick and was not able to go back to the hospital and process her
registration;

7. That a copy of her birth certificate is needed for the purpose of late registration
and to have a record in the Philippine Statistics Office.

ANGELY ABAN BAGUIO

Affiant

SUBSCRIBED AND SWORN to before me this 28TH day of October, 2018, in

Cebu City, Philippines. Affiant exhibiting to me her I.D. UMID 0111-7072613-2.

Doc No._____;
Page No. _____;
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Series of 2018.