Republic of the Philippines)

Province of Cebu )
Municipality of Liloan )S.S.

AFFIDAVIT FOR DELAYED REGISTRATION OF BIRTH

I, JELMAR ANDRECOSO ESCOTO, of legal age, single, Filipino and with residence
and postal address at Brgy. Sta. Cruz, Liloan, Cebu, Philippines after having been duly
sworn to in accordance with law, do hereby depose and say:
1. That I am applying for delayed registration of my birth;

2. That I was born on September 30, 1989, at Cebu City, Philippines;

3. That I only reach grade four in my educational attainment;

4. That from the time I find work, in construction, they do not require any birth
certificate from me, but only my Baptismal Certificate, as attached;

5. That in the year 2016, when I applied for work in ASPA Formwork-Systems, Inc.,
they asked a copy of my birth certificate;

6. That when I process it, both in the Local Civil Registrar and NSO, they found a
negative entry of my birth;

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

8. That I execute this affidavit to attest to the truth of foregoing facts.

JELMAR ANDRECOSO ESCOTO

Affiant

SUBSCRIBED AND SWORN to before me this 12 th day of January 2019, in

Liloan, Cebu, Philippines. Affiant exhibiting to me her I.D. SSS No.06-3638070-9.

Doc No._____;
Page No. _____;
Book No._____;
Series of 2019.