Republic of the Philippines )

Province of Leyte ) S.S

City of Baybay )

AFFIDAVIT OF BIRTH BY TWO DISINTERESTED PERSONS

We, HELENA V. BORINAGA and NESTOR G. BASIBAS, both of

legal ages, Filipinos, and residents of Brgy. Cogon, Baybay City, Leyte,
having been duly sworn in accordance with law, do hereby depose and
say;

1. That we personally know LIONNE T. PANGILINAN of Brgy.

Villa Solidaridad, Baybay City, Leyte, being acquainted for a long
time;

2. That she is a PAG-IBIG Fund Member with an application for

Provident Benefits with the Fund;

3. That the said application is required to be accompanied by a

copy of the applicant’s birth certificate, however, no record can
be obtained, as shown by the attached Certification of Non-
Availability of Birth Record from the Philippine Statistics
Authority (PSA);

4. That we certify that she was born in Eastern Visayas Regional

Medical Center, Tacloban City, Leyte, Philippines, on May 22,
1986;

5. That she has been using the said birth date in all her documents
and transactions, including her education and employment
records;

6. That we are not related by affinity or consanguinity to the

above-mentioned person;

7. That we are executing this affidavit to attest to the truth of the

foregoing facts for record and references purposes.

IN WITNESS WHEREOF, we have hereunto set our hands this

September 27, 2023, at Baybay City, Leyte.

1
HELENA V. BORINAGA NESTOR G. BASIBAS
Affiant Affiant
ID No: 0202 ID No: 0529
Type of ID: OSCA-Baybay City, Leyte Type of ID: OSCA-Palo, Leyte

SUBSCRIBED AND SWORN to before me, this September 27,

2023 in Baybay City, Leyte, by affiant who exhibited to me his
competent evidence of identity written below his name and bearing his
photographs and signatures, known to me to be the same persons who
executed the foregoing Affidavit.

Doc No.: 24;

Page: 06;
Book: XXVII;
Series of 2023