REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF TABUELAN ) S.S.

JOINT – AFFIDAVIT OF
TWO DISINTERESTED PERSONS

We, Rhea Mae Dotillos Montejo and Vincent Cole Comeros, both of legal age,
Filipinos, and both residents of Barangay Poblacion, Municipality of Tabuelan, Cebu,
after having been duly sworn in accordance with law, do hereby depose and say, THAT:

1. We personally know PABLO MONTERMOSO MASOCOL JR. (Pablo, for brevity)

because we have been friends and neighbors for a long time.

2. In his SSS Form E-4 dated 22 March 1984 with SSS No. 06-0665207-2, Pablo
erroneously indicated as his Last Name -“MASUKOL” which is contrary to that with
his Last Name in his PSA copy of Certificate of Live Birth - “MASOCOL” due to his
honest belief that the former is the correct spelling thereof;

3. PABLO MONTERMOSO MASOCOL JR. And PABLO MONTERMOSO MASUKOL

JR. are one (1) and the same person;

4. We are not in any way related to PABLO MONTERMOSO MASOCOL JR. within
the 4th degree by affinity nor consanguinity;

5. That finally, we are executing this affidavit for the purpose of informing the
authorities especially the Social Security System (SSS) Personnel/Officers of the
above-mentioned fact/s or circumstance/s and to support his Member Data Change
Request to change his Last Name from “MASUKOL” to “MASOCOL”. This affidavit
is based on personal knowledge.

IN WITNESS WHEREOF, we hereby affix our signatures, this September 24, 2022 at
Municipality of Tabuelan, Cebu, Philippines.

Affiants:

Rhea Mae Dotillos Montejo Vincent Cole Comeros

VIN: 2249-0009B-K3092RDM20000 Driver’s License No. G06-14-012098

SUBSCRIBED AND SWORN to before me on September 24, 2022 at Municipality of

Tabuelan, Cebu, Philippines. Affiants exhibited to me their competent proof of
identification as indicated above.

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