REPUBLIC OF THE PHILIPPINES }

CITY OF CALAMBA } S.S.

x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x

JOINT AFFIDAVIT
FOR DELAYED REGISTRATION OF BIRTH

WE, ANGELICA DIZON SAPLANA and SONIA P. LOGDAT, both of legal age, married and
single, respectively, Filipino citizens and residents of Bagong Kalsada Calamba City, Laguna, after
having been duly sworn to in accordance with law hereby depose and state:

1. That we personally know one JOHN KIAN PANTONE who was born on February 5,
2016 in BARANGAY HEALTH STATION Brgy. Bagong Kalsada, Calamba City, Laguna,
to mother REYNALYN IDIO PANTONE.

2. That we know for a fact that his/her birth was not duly registered with the Office of the
Local Civil Registrar, Calamba City, due to lack of necessary requirements needed for
registration of his/her birth;

3. That it is only now that they are causing the registration of his/her birth with the Office
of the Local Civil Registrar of Calamba City, Laguna;

4. That we know all of the foregoing facts because we are close friends of his/her parents;

5. That we executed this affidavit to attest to the truth of all the facts mentioned above and
for all legal intents and purposes.

IN WITNESS WHEREOF, I hereunto affixed my signature this affidavit this __ th day of

________at Calamba City.

ANGELICA DIZON SAPLANA SONIA P. LOGDAT

Affiant Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this ___th day of ________ at Calamba City.

WITNESS MY HAND AND SEAL . . . . . . . . . . . . . . . . . . . . . . .

Doc. No. ; ATTY. REINIER JOHN G. BROFAR

Page No. ; Notary Public
Book No. ; Calamba City, Los Banos, Bay, Calauan, Laguna
Series of 2021 Not. Com. No. 09-2021-C; Until December 31, 2022
Roll No. 59463; IBP No. 130502/10-14-20/Laguna
PTR No. 7636500/01-04-2021/Calamba City
MCLE Compliance No. VI-0005183/11-27-17