Republic of the Philippines)

Province of Surigao del Sur)

Municipality of Tago..)

AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, ALBERTO DELLIZO ESPINOZA and MARIA CHARLITA C.

QUINTANA, Filipinos, both of legal age, and residents of Tago, Surigao
del Sur, Philippines, after having been duly sworn to in accordance with
the law, depose, and state:
1. That we personally know JOSEPHINE LODECHO
BANGOY, she being our close family friend and neighbor;

2. That we have personal knowledge that JOSEPHINE

LODECHO BANGOY was born on September 07, 1970 to spouses
ODELON SR. ACEVEDO BANGOY and FE CALAMBA LODECHO at
Tago, Surigao del Sur;

3. That the said birth was not registered within thirty (30) days
therefrom with the Local Civil Registrar of Tago, Surigao del Sur due to
the negligence of the parents and to date, it remains unregistered;

4. That we are executing this Affidavit to attest the veracity of

the foregoing and in compliance with the requirements of the Local Civil
Registrar of Tago, Surigao del Sur, relative to the application for delayed
registration of the birth of JOSEPHINE LODECHO BANGOY and for
whatever legal purposes this may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this 31 st

day of July, 2019 at Tago, Surigao del Sur.

ALBERTO DELLIZO ESPINOZA MARIA CHARLITA C. QUINTANA

Affiant Affiant
SUBSCRIBED AND SWORN to before me this 31st day of July, 2019
at Tago, Surigao del Sur.

Doc No.: 23
Page No.: 6
Book No.: XVI
Series of 2019