Republic of the Philippines}

City of Cebu}S.S.

AFFIDAVIT OF CORRECTION

I, NONA CAGAWAS NAZARENO, Filipino, of legal age, and resident of

Cabcaban, Barili, Cebu, after having been duly sworn to in accordance with law, hereby
depose and state that:

1. I am the legal wife of the deceased Eddie Nazareno who died on 4 December
2021.
2. Because I was anxious and distraught over his death, in his Certificate of
Death, his date of birth was erroneously put in as Sept. 10, 1959. But his true
date of birth as reflected in his Birth Certificate is Sept. 11, 1962. Attached
herewith is his Birth Certificate for reference.
3. Also, in his Certificate of Death, the name of his mother was erroneously put
in as Caridad Eborda. But the true and correct name of his mother as reflected
in our Marriage Certificate is Caridad Alfafa. Attached herewith is our
Marriage Certificate for reference.

4. I declare, confirm and affirm that Eddie Nazareno’s date of birth is Sept. 11,
1962 and his mother’s name is Caridad Alfafa.

5. The erroneous information provided in the said Certificate of Death with

respect to his date of birth and mother’s name is due to anxiety and mere
inadvertence by the informant.

6. I am executing this affidavit to confirm and affirm the foregoing facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _ day of

January 2022 at Cebu City, Philippines.

NONA CAGAWAS NAZARENO

Affiant

SUBSCRIBED AND SWORN to before me this _ day of January 2022 at

Cebu City, affiants exhibiting to me their competent evidence of identity.

Doc. No.: _
Page No.: _
Book No.: 4
Series of 2022.