Republic of the Philippines)

Province of Eastern Samar)

Municipality of Llorente )S.S.

AFFIDAVIT OF BIRTH

I, RUFINA BORJA, of legal age, Filipino, widow, resident of Brgy. San

Miguel, Llorente, Eastern Samar after being sworn to in accordance with law depose
and state, THAT:
1. I am the niece of MARIO GILLO BORJA;
2. MARIO was born on 20 November 1950 in Brgy. San Miguel, Llorente,
Eastern Samar;
3. MARIO died on 5 February 2021;
4. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF I have set my hands this 6th day of September

2022 in Llorente, Eastern Samar.

RUFINA BORJA
Affiant

SUBSCRIBED AND SOWRN to before me this 6th day of September 2022 at

Llorente, Eastern Samar, affiant showed to me competent proof of identity
consisting of her TIN No. 511-144-264-000 issued on 11/27/2021 by the BIR.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2022.