REPUBLIC OF THE PHILIPPINES)

) SS.
DONE: )

AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, AAA and BBB, both of legal age, Filipino, single, residents of Sablan, Palali,
Benguet and Gibraltar, Baguio City respectively, after having been duly sworn to in
accordance with law, hereby depose and state:

1. That we personally know REGGIE DARIAN MILLER of Barangay Loacan, Itogon,

Benguet;

2. That we are fully aware and cognizant of the above-stated facts because we are
friends and acquainted with each other;

3. That we learned that REGGIE BARIAN MILLER was previously registered in the
records of the Social Security System (SSS) as “REGGIE MARIAN MILLER”, with
birth date February 8, 1959, instead of REGGIE DARIAN MILLER, with birth date
January 3, 1959 as appearing in REGGIE DARIAN MILLER’s NSO Certificate of
Live Birth;

4. That the names “REGGIE MARIAN MILLER”, with birth date of February 8, 1959,
(as appearing in the record of SSS), and REGGIE DARIAN MILLER, with birth date
of January 3, 1959 (as appearing in REGGIE DARIAN MILLER’s NSO Certificate
of Live Birth) refer to one and the same person;

5. That we are both disinterested parties;

6. That we are not related by consanguinity or affinity to the above-named

persons;

7. That we are executing this Affidavit to attest to the truthfulness of the foregoing
and for all legal intents and purposes.

AFFIANTS further sayeth no more.

IN WITNESS WHEREOF, WE have hereunto set our hands this day of August, in
the , Philippines.

AAA BBB
Affiant Affiant

SUBSCRIBED AND SWORN TO before me this day of August, in the , Philippines.

Affiants having exhibited to me their ID’s bearing number as above-indicated below their names with
their picture and signature as proof of their identity.