REPUBLIC OF THE PHILIPPINES)

CITY OF SAN PABLO ) S.S

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

RE: ONE AND THE SAME PERSON

WE, __________ and _________, both of legal ages, Filipinos, married, respectively and both
are residents of _____________________, after having been sworn in accordance with the
law hereby depose and state that;

1. We personally know ________________, who is our long time neighbor and

acquaintance at _____________________, and the fact of his birth is registered at
the Local Civil Registrar of ___________________;

2. We know for a fact that the person by the name of "_____________" as appearing in
some documents or specifically in his Certificate of Live Birth and identification cards
and the name "___________________" as appearing in his school records, refer to
one and the same person and that his true and correct name is
__________________;

3. We are not in any way related to any of the foregoing person within the fourth civil
degree either by consanguinity or affinity, nor do we have any pecuniary interest in
this matter whatsoever;

4. To remove confusion as to the two names, we hereby declare that the name
__________________ and ________________ refer to one and the same person
whose registered name is ________________;

5. We are executing this affidavit to attest to the truthfulness of the foregoing

statements and to establish the real identity of __________________ and for all
legal intents and purposes it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this 18th day of February 2014 at
__________, Philippines.

_____________________ __________________
Affiant Affiant
SSS ID No: 01-1600990-8 PRC ID No: 0003384
Valid until: 11/12/2016

SUBSCRIBED AND SWORN TO before me this 18th day of February 2014 at _________
Philippines.

___________________________
Notary Public
Until December 31, 2015
PTR No._________; IBP No. _______
1-02-14/____________

Doc. No.___;
Page No. ;
Book No. XXIV;
Series of 2014.