Republic of the Philippines )

__________………………………)SS.
x----------------------------x

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

(FOR DELAYED REGISTRATION OF BIRTH)

WE, Nelson C. Layugan and Lazaro De Leon Cayana, both of legal age,
Filipinos and all residents of 354 and 264-E Ilang Ilang Street, Bancal. Meycauayan
Bulacan, after having been duly sworn to in accordance with law, do hereby depose
and state that:

1. We know the facts and circumstances surrounding the birth of the child
named Rosario Cayana Layugan who was born on January 09, 1969 at
Meycauayan City, Bulacan to his/her biological parents Rodolfo Batarao
Layugan and Carmen De Leon Cavana, both being our personal
acquaintances/neighbors;

2. The said child was born outside of wedlock;

3. “The birth of the said child was attended by Aling Medring a Traditional
Hilot of Meycauayan”)

4. The said child was immunized and (but not yet) baptized since one of the
requirements for baptism is the child’s birth certificate which is still being
applied for delayed registration (omit if already immunized and baptized);

5. The birth certificate of the said child was not immediately registered with
the Office of City Civil Registrar, Meycauayan, Bulacan, primarily because
of the inadvertence of the parents or failure of the person(s) delegated to do
so, hence, this Joint Affidavit;

6. The birth certificate of the said child is not registered with any Office of
the Local/Municipal/City Civil Registrar;

7. We are executing this Joint Affidavit to attest to the truth of the foregoing
facts of birth and to support the application for delayed registration of the same
with the Office of the City Civil Registrar, Meycauayan, Bulacan.

IN WITNESS WHEREOF, we have hereunto set our hands this _____________

at _______________________.

Lazaro De Leon Cayana Nelson C. Layugan

_________________ _________________
Affiant Affiant
ID No. Senior I.D. 4549_______ ID No.1412-0076A
Valid until 2022 Valid until 2022

SUBSCRIBED AND SWORN to before me this _______________ at

_________________.

Doc. №:________________; NOTARY PUBLIC

Page №:________________;
Book №:________________;
Series of 2016.