Republic of the Philippines ]

Province of Bohol ]
Municipality of Carmen ] S.S.

JOINT SUPPLEMENTAL AFFIDAVIT

We, WILBERT P. BALBIN and FLOREDELES O. BAUTISTA, Filipinos, of legal

ages, married to each other and residents of Buneavista, Carmen, Bohol, Philippines, after being
duly sworn in accordance with law, hereby depose and say:

1. That we are the biological parents of JANE BAUTISTA, who was born on
December 5, 2021 at Cong. Simeon G. Toribio Memorial Hospital, Carmen, Bohol,
Philippines;

2. That at the time that our child was born, I, FLORDELES O. BAUTISTA, was still
seventeen (17) years old;

3. That I, FLORDELES O. BAUTISTA, was born on May 12, 2004;

4. That we got married last December 26, 2022 at Fatima Shrine-Buenavista, Carmen,
Bohol with our solemnizing officer Rev. Msgr. Ariel L. Lantaca;

5. That we are executing this document to support the legitimation of our child JANE
BAUTISTA;

6. That further, I execute this affidavit for whatever legal purpose this may serve.

IN WITNESS WHEREOF, we hereunto set our hands this 17th day of March, 2023 at
Carmen, Bohol, Philippines.

WILBERT P. BALBIN FLOREDELES O. BAUTISTA

Affiant Affiant
National ID No. 5810-4370-5492-3652 VIN: 12120024CE1204FOB20000-2
Issued by the Philippine Statistics Authority Issued by the Commission on Elections
(PSA) (COMELEC)
Carmen, Bohol

SUBSCRIBED AND SWORN TO before me this 17th day of March, 2023 at Carmen,
Bohol, Philippines.