Republic of the Philippines)

Province of Surigao del Sur)

City of Tandag) S.S.

AFFIDAVIT OF LEGITIMATION
AND USE OF SURNAME

We, Spouses ELICITO PIA MEDRANO and ARLENE TORAJA MEDRANO, of legal
age and residents of Tago, Surigao del Sur, state under oath, THAT:

1. We are the biological parents of MARK RICHARD T. TORAJA and MARK

ANTHONY T. TORAJA, born on September 23, 1990 and November 12, 1993, respectively;

2. Our two children were born before our marriage, as we have been living together as
common law partners, hence, they are considered illegitimate children;

3. On March 24, 1994, we married each other at the Roman Catholic Chapel in Umbay,
Tago, Surigao del Sur;

4. Having been legally married, Mark Richard and Mark Anthony have acquired
legitimate status by virtue of law;

5. However, having been born before the effectivity of R.A 9255 otherwise known as
Revilla law, our children are using the surname TORAJA and middle name TABA, all of their
mother’s maiden name, as what appeared in their certificates of live birth issued by NSO;

6. We are executing this affidavit to affirm the legitimate status of our children, named
above, to apprise and request the concerned agencies (LCR of Tago, Surigao del Sur and
NSO) that our children be allowed to use the surname MEDRANO, and thereby modify their
existing records from MARK RICHARD TABA TORAJA to MARK RICHARD TORAJA
MEDRANO and MARK ANTHONY TABA TORAJA to MARK ANTHONY TORAJA MEDRANO
and their status in this act of legitimation.

IN WITNESS WHEREOF, we have hereunto set our hands this _________ day of April
2015, in Tandag City, Surigao del Sur, Philippines.

ELECITO P. MEDRANO ARLENE T. MEDRANO

SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and in the Province
of Surigao del Sur, this ________ day of April 2015, in Tandag City, Surigao del Sur, the affiants
personally appeared and affixed their signatures and presented their ID’s as proof of identities .

ANDREI ARREZA ANDRESAN

Notary Public
Until December 31, 2015
IBP No. 811366; Jan. 5, 2015; Surigao del Sur
PTR No. 5427379; Jan. 6, 2015; Surigao del Sur
IBP Roll No. 41883
MCLE Compliance No. IV-0013490
Misc. Case No. 05-2014

Doc. No. ______; Page No. _______; Book No. _______; Series of 2015