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We, AAAAAA and BBBBBBBBB of legal age, Filipino Citizens and residents of
Roxas City, Capiz, having been duly sworn to in accordance with law, depose and state:
1. That we personally know CCCCCCCC; that he died as per death certificate with
registry no. 5435345;
2 That it is a public knowledge in our community and close friends that the mother
of CCCCCCC is DDDDDDDD;
3 That CCCCCCCC and EEEEEEE are married as evidenced by a Marriage
Certificate, however the parents of the spouses were erroneously stated as
EEEEE instead of ZZZZZZ ;
4 That the true and correct name of the mother is CCCCCCCC;
5 That we are not related by affinity by consanguinity to the above named
persons.
We are executing this Affidavit for the purpose of informing the authorities
concerned of the veracity of the foregoing facts and to declare that CCCCC is the true
mother of DDDDDD and not EEEEE as stated in his Marriage Certificate.
AAAAAAAAAAAAA BBBBBBBBBBBB
Affiant Affiant
ID: OSCA: 546546 ID: PH ID: 234234324