Republic of the Philippines)

Province of Negros Oriental..) S.S.

Municipality of Sibulan)

JOINT AFFIDAVIT
OF TWO DISINTERESTED PERSONS

That we, BRILLE CAVIN F. FORTIT, of legal age, Filipino and a resident of Magatas,
Sibulan, Negros Oriental and RUBEN M. DELA CERNA, JR., of legal age, Filipino and a
resident of Poblacion, Sibulan, Negros Oriental, Philippines, under oath, do hereby depose and
manifest:

That we personally know the person of “ERICA MAE SIMIL” and that recently we
came to know that her name as indicated in the DSWD Financial Assistance Beneficiary
List/Data/Record was “LIZICA SEMIL” and we know for a fact that the person of “LIZICA
SEMIL” as appearing in the DSWD Financial Assistance Beneficiary List/Data/Record and the
name “ERICA MAE SIMIL” as appearing in her National ID No. 3540-5389-3428-1274,
REFERS TO ONE AND THE SAME PERSON, the latter being the correct and real name;

Perhaps, the incorrect entries were due to honest mistake and inadvertence. That we
know of these facts considering that we are acquiantances and friends of her, and that neither of
us is related with her either by affinity or consanguinity and that we are executing this joint
affidavit freely and voluntarily in order to attest to the veracity of the facts above stated and for
whatever legal purposed this may serve best;

IN WITNESS WHEREOF, we have hereunto affixed our signatures this

____________________, at Sibulan, Negros Oriental.

BRILLE CAVIN F. FORTIT

(Affiant)
ID: National ID No. 3497-1087-2642-7452

RUBEN M. DELA CERNA, JR.

(Affiant)
ID: National ID No. 2903-7934-7204-8915

SUBSCRIBED AND SWORN to before me this __________________, in Sibulan,

Negros Oriental, Philippines, personally appeared the above-named persons and exhibited to me
their respective proofs of their identity written below their respective name and signature,
personally known to me and known to me that they are the same persons who appeared and
signed the foregoing Joint Affidavit of Two Disinterested Persons in my presence within my
jurisdiction, and who avowed to the truth of its content under penalty of law.

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