REPUBLIC OF THE PHILIPPINES )

PROVINCE OF ______________ ) S. S.
CITY OF __________________ )

AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, ______________________________, both of legal age, and residents

of__________________________, after having been duly sworn to in accordance with law
hereby depose and state:

1. That we personally know _____________________ who, out of wedlock, was born

by his parents ______________ and ____________ on ____________;

2. That in his Certificate of Live Birth issued by the Philippine Statistics Authority and
the original Certificate of Live Birth issued by the Local Civil registry of
_______________ his name was written as “_______________”;

3. That, however, in his Baptismal Certificate issued by the______________________,

his name was written as “___________________” instead of
“_____________________,” his true and correct. Likewise in the
same________________, it appears that the name of his mother was written as
“_______________” instead of “____________________,” the true and correct
name of his mother;

4. That to the best of our knowledge “____________,” the name appearing in his
Certificate of Live Birth, and “_________________” are one and the same person;

5. Likewise, “________________,” the name of his mother appearing on his Certificate

of Live Birth, and “____________________,” the name of his mother appearing in
his Baptismal are also one and the same person;

6. That we know this fact because the family of _________________is our neighbor;

7. That we executed this affidavit to attest the above-stated facts and for whatever
legal purpose this may serve him best;

IN WITNESS WHEREOF, we have hereunto signed our names this ____________ at

_______________.

Affiant Affiant
________________ ______________

SUBSCRIBED AND SWORN to before this ________________________ at

_____________.

Doc No. ______;

Page No. _____;
Book No. _____;
Series of 2018.