REPUBLIC OF THE PHILIPPINES
PORVINCE OF MASBATE,
MUNICIPALITY OF PLACER
AFFIDAVIT OF TWO DISINTERESTED PERSONS
‘That We, AMELITA 0, BULAN of legal age, Filipino citizen, married and resident of
Pasiagon, Placer, Masbate, and NENE B. CONDRILLON of legal age, Filipino citizen, married
and resident of Pasiagon, Placer, Masbate, afier having been duly sworn to, depose and say:
1. That we personally know JAIME DELA PISA CALIPAY, who was bon to SELVINA
E. DELA PISA and PEDRO B. CALIPAY, on June 03, 1955, was considering that we
are long acquaintances:
2. That we know that his correct name was JAIME DELA PISA CALIPAY, as shownin
his Certificate of Live Birth.
3, However, when his daughter was registered to Municipal Civil Registrar, his name and
surname was misspelled as JIMMY CALIPAY and JAIME DELA PISA as shown of
their Certificate of Live Birth.
4, That we attest that the names JAIME DELA PISA CALIPAY, (per Birth Certificate),
and JIMMY CALIPAY and JAIME DELA PISA, (per Certificate of Live Birth of his
daughter) refer to one and the same person.
5. That we are not related in anyway, by consanguinity or by affinity to the said JAIME
DELA PISA CALIPAY.
6. That we are eexecuting this affidavit for whatever legal purposes it may serve.
IN WITNESS WHEREOF, We have hereunto set our hands this 1 day of December
2023, at Placer, Masbate, Philippines.
AMELITA O. BULAN NENE B. CONDRILLON
Affiant Affiant
SUBSCRIBED AND SWORN to before me this 1 day of December 2023, Affiant was
personally examined by me and I am satisfied that affiant freely and voluntary executed his
affidavit and acknowledged to me that the same is true and correct to the best of her personal
knowledge and based on authentic records.
sh ATTY, JAIME D. ees
Doc. No.
NOTARY PUBLIC
COM, EXPIRES JUNE 21,2024
Book No. _ XX PTR NO, 1086185 02-15-23
NASBATE
i ROLL OF AVIGRNEY 23735
Series of 2023