Republic of the Philippines)

City of Cebu………………) S.c.

JOINT AFFIDAVIT

WE, CELERINA C. GEMARINO, LAURINA B. ESPERA, of legal age, Filipino, widow

and residents Colonia, Tuburan, Cebu, after having been duly sworn to in accordance with law,
do hereby depose and state that—

1. We are residents of Brgy. Colonia, Tuburan, Cebu all our lives;

2. We know Spouses Romeo P. Policios and Marcosa C. Policios because they are our
neighbors for a very long time;
3. We also know their children; namely: MA. REBECCA POLICIOS-GOMERA,
MARILOU POLICIOS-ROBUSTO, REYNALDO C. POLICIOS, MARIE GRACE
POLICIOS, ROBERTO C. POLICIOS, MA. CECELIA POLICIOS-DANIOT and
MARVIE C. POLICIOS;
4. Recently, a death claim has been filed before the Social Security System Office due
to the death of Romeo P. Policios and on SSS E-1 Form, inconsistencies on the
names and dates of birth of the dependents were found out, to wit:

MARIVIC POLICIOS
Date of Birth: April 25, 1967
ROBERTO POLICIOS
Date of Birth: November 7, 1969
LOTA POLICIOS
Date of Birth: December 10, 1971
RONALD POLICIOS
Date of Birth: October 30, 1975
MARCOSA CONSOLACTION
Date of Birth: October 7, 1948

5. As far as our memories serve as right, the correct names and dates of their birth are as
follows:

FROM TO

MARIVIC POLICIOS MA. REBECCA POLICIOS-GOMERA

Date of Birth: April 25, 1967
ROBERTO POLICIOS
Date of Birth: November 7, 1969
LOTA POLICIOS
Date of Birth: December 10, 1971
RONALD POLICIOS
Date of Birth: October 30, 1975
MARCOSA CONSOLACTION
Date of Birth: October 7, 1948
Date of Birth: April 25, 1966
ROBERTO POLICIOS
Date of Birth: November 17, 1969
MARILOU POLICIOS-ROBUSTO
Date of Birth: June 24, 1972
RENARDO POLICIOS
Date of Birth: October 31, 1975
MARCOSA CONSOLACION
Date of Birth: October 7, 1947

6. The aforesaid names in paragraph 5 were mistakenly entered by ROMEO P.

POLICIOS, the father of the foregoing for reasons only known to him;

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

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __ day of

______________ in the City of Cebu, Philippines.
 CELERINA C. GEMARINO LAURINA B. ESPERA
AFFIANT AFFIANT
NID 6185-2905-9630-9731 NID 6951-8459-8379-4278

SUBSCRIBED AND SWORN TO before me this __ day of __________________ in the

________________________, Philippines.

Doc. No. __
Page No. __
Book No. __
Series of 2023.