REPUBLIC OF THE PHILIPPINES )

__________________________ ) S.S.
X ----------------------------------------------- X

JOINT-AFFIDAVIT

We, ______________and ______________, of legal age, Filipinos, the first party

______________and the second ______________, and residents of ______________,
Philippines, after having been sworn to in accordance with law, depose and say that:

1. We know the persons of ______________and ______________who are married.

However, shortly after their marriage, said spouses went their separate ways and
we have not known the whereabouts of ______________;

2. In ______________, ______________ and ______________ lived together as husband and

wife without the benefit of marriage and they established their dwelling at
______________. In the course of their cohabitation, they begot ______________
child/ren in the name of ______________;

3. ______________ and ______________cohabited until the death of ______________on

______________at ______________. ______________was the one who shouldered all
the medical and funeral expenses of the deceased ______________ in relation to his
death;

4. The location of the said estranged wife ______________is not known and said person
cannot be located. Likewise, we have no information whatsoever whether or not she
is still alive. ______________ has exhaustively and diligently looked for his
whereabouts but all efforts were in vain; and

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

IN WITNESS WHEREOF, we have hereunto set our hands this ______________ at

______________, Philippines.

______________ ______________
Affiant/______________ Affiant/______________

SUBSCRIBED AND SWORN to before me this Affiant/______________ at

Affiant/______________J. Affiants exhibited to me their competent evidence of identity as
above-indicated.

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