Republic of the Philippines )

Province of Cotabato ) S.S

City of Kidapawan )

AFFIDAVIT FOR DELAYED REGISTRATION OF LIVE BIRTH

I, _ARNEL M. ALFORTE_, of legal age, married, with residence and postal address at
_Poblacion, City of Kidapawan, Cotabato _, after having been duly sworn to in accordance with law,
do hereby depose and say:

That, I am the applicant for an Out-of-Town registration of my birth/the birth of

__ REGINO BOLASA CAMIGUING __;

That, I/he/she was born on _07 September 1943_ at _LINANGKOB, KIDAPAWAN,

COTABATO, COTABATO_, of parents, _MARIO ROA BOLASA and _BRIGIDA CAÑEDA
CAMIGUING_;

That, the fact of my/his/her birth was not promptly reported at the Office of the Civil
Registrar of _COTABATO CITY_ due to our inadvertence;

That I am executing this affidavit to attest to the truth of the foregoing statement and to prove
the facts for an Out-of-Town registration of my birth, pursuant to Rule 20, Administrative Order No.
1, series of 1993.

IN WITNESS WHEREOF, I have hereunto set my hand this _20TH _ day of _OCTOBER _,
2022 at Kidapawan City, Cotabato.

ARNEL M. ALFORTE
ID NO: __________________

_____________________________________________________________________________________________

AFFIDAVIT OF CORROBORATION

We, CHERYL F. ELEAZAR and RICO N. RENEGADO, both of legal ages, Filipino Citizens and are
both residents of Poblacion, Kidapawan City, after having been duly sworn to in accordance with law, do hereby
jointly depose and say:

That, we know the above-stated facts because we have personal knowledge of the facts stated therein
considering that we are friends and neighbors for a time.

That, we executing this affidavit to attest the veracity of the foregoing statement.

Signed this _20th _ day of __October__, 2022 at Kidapawan City, Cotabato, Philippines.

_____ _____ _____ _____

(Signature of Affiant) (Signature of Affiant)
ID NO. ____________ ID NO. ______________

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SUBSCRIBED AND SWORN to before me this 20 TH day of October 2022 at Kidapawan City,
Cotabato, Philippines.