Republic of the Philippines )

City of Cebu )
x----------------------------------y

AFFIDAVIT OF TWO DISINTERESTED PERSONS

That We, _________________ and _________________, of legal ages, both

Filipino and residents of Caurasan, Carmen, Cebu, Philippines, after having sworn
to in accordance with law, hereby depose and state that:

1. We personally know ________________, of legal age, Filipino, married, a

resident of Taguini, Caurasan, Carmen, Cebu, Philippines, and born in
January 14, 1962, being a longtime acquaintance and neighbor;

2. We know for a fact that the name ___________ as appearing in his

baptismal certificate and __________ as appearing in his COMELEC Voter’s
ID, BIR TIN ID and Philhealth ID refer to one and same person and that his
true and correct name is ____________;

3. We are not in any way related to _________ within fourth civil degree of
consanguinity or affinity and do not have any pecuniary interest to him;

4. We are executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose this may serve.

IN WITNESS WHEREOF, We have hereunto affixed our signatures this

________________ at Cebu City, Philippines.

_____________________ _____________________
_____________________ _____________________

SUBSCRIBE AND SWORN TO before me this ______________at Cebu

City, Philippines, affiant exhibited their competent proof of identify as sanctioned by
the Rules.

Doc. No. _____;

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