You are on page 1of 1

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BUKIDNON ) SS
CITY OF VALENCIA )

JOINT AFFIDAVIT OF TWO


DISINTERESTED PERSONS

We, MICHAEL RHENZ M. CALZADA and MARY JOY R. LOZARITA, both of


legal age, both Filipino citizens and residents of Kahaponan, Valencia City, Bukidnon
and Purok 10, Lumbo, Valencia City, Bukidnon, respectively, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

1. That we personally know BARBIEY JEAN CADIVIDA ANGCAY for more


than five (5) years;

2. That the name BARBIEY JEAN CADIVIDA ANGCAY is the correct spelling
of her name as reflected in her Certificate of Live Birth;

3. That, however, in her Social Security System (SSS) record, her name was
indicated as BARBIEY JEAN ANGCAY instead of the correct name
BARBIEY JEAN CADIVIDA ANGCAY;

4. That the discrepancy in the name BARBIEY JEAN ANGCAY in the said
Certificate of life birth and BARBIEY JEAN ANGCAY in the said Social
Security System (SSS) records actually refer to one and the same person;

5. That we have executed this statement to explain the


discrepancy/inconsistency in the above mentioned document;

6. That this instrument is being executed for Social Security System (SSS)
records and for the purpose of attesting to the veracity of the foregoing facts
and in order to appraise the authorities concerned.

IN WITNESS WHEREOF, we have hereunto affixed my signature this 15 th of


March 2023, at Valencia City, Bukidnon.

MICHAEL RHENZ M. CALZADA MARY JOY R. LOZARITA


Affiant Affiant
CEI: CEI:

SUBSCRIBED AND SWORN to before me, this 15 th of March 2023, at Valencia


City, Bukidnon.

Doc. No.: ___;


Page No.: ___;
Book No.: ___;
Series of 2023.

You might also like