REPUBLIC OF THE PHILIPPINES )

CITY OF _______ ) S.S.

JOINT AFFIDAVIT OF DISINTERESTED PERSONS

We, __________and ____________, both of legal age, Filipinos and residents of

__________ after having been duly sworn to in accordance with law, do hereby depose
and say:

1. That we personally know ___________o, since acquaintance for a long period

of time;

2. We know for a fact that ____________ is a single parent;

3. We are aware that she is married yet her husband has abandoned her and her
children since 2017;

4. That she was left alone with the sole responsibility of parenthood and
provide for the needs of her children;

5. That we are in any way related to _____________ by consanguinity or affinity,

nor do we have pecuniary interest in this matter;

6. That we are executing this affidavit to attest the truth of the foregoing facts for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this ___ day of
________ at _____________.

Affiant Affiant

SUBSCRIBED AND SWORN to before me this ______ day of ____________ in

______________ at _____________.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 202____.