Anda di halaman 1dari 4

Republic of the Philippines }

Province of Samar } S.s


City of Calbayog }
A F F I D A V I T
I, MARLENE S. CABRILLAS, Filipino, widow, of legal age and a
resident of rgy. !brero,Calbayog City, after having duly sworn in
accordance with law hereby deposes and says"
#. $hat I am the mother of ROMAR SIBULLAS CABRILLAS
%. $hat his Certi&cate of 'ive irth has erroneous entry, to wit"
2.1 his gender was recrded as FEMALE ins!ead "
MALE#
(. $hat I am already on the process of instituting an appropriate
action for the correction of entry in his Certi&cate of 'ive
irth)

*. $hat the foregoing is e+ecuted to attest to the veracity and
truthfulness of the foregoing statements and for whatever
other legal purposes this may serve.
F,R$-.R, I S/0.$- 1/,2-$.
MARLENE S. CABRILLAS
/3ant
Subscribed and sworn before me, this 44day of 5.C.6.R %7#(,
at Calbayog City.
Republic of the Philippines }
Province of Samar } S.s
City of Calbayog }
A F F I D A V I T
I, ROSARIO L. SENAN$OTE, Filipino, married, of legal age and a
resident of rgy. Cabacungan, !8uendo 5istrict, Calbayog City, after
having duly sworn in accordance with law hereby deposes and says"
# $hat I am the mother of ROMEO LIRA% SENAN$OTE, an
employee of private sector in 5igos City, 5avao)

% $hat his Certi&cate of 'ive irth has the erroneous entries, to
wit"
%.# his 5ate of irth was recorded as 1ovember %7, #9:9
instead of 1ovember %#, #9:9
( $hat I am already on the process of instituting an appropriate
action in Court for the correction of entry in his Certi&cate of
'ive irth)

* $hat the foregoing is e+ecuted to attest to the veracity and
truthfulness of the foregoing statements and for whatever
other legal purposes this may serve.
F,R$-.R, I S/0.$- 1/,2-$.
ROSARIO
L.SENAN$OTE
/3ant
Subscribed and sworn before me, this %;
th
day of September
%7#(, at
Calbayog City.
Republic of the Philippines }
Province of 'eyte } S.s
City of $acloban }
&OINT AFFIDAVIT OF T'O DISINTERESTED (ERSONS
<e, 444444444444444444444 and 444444444444444 both Filipino, married, of
legal age, with residence address at 4444444444444, respectively, after
having duly sworn in accordance with law hereby depose and say"
#. $hat the Regional !3ce = building, located at >anhuraw -ill,
$acloban City, was ra?ed by &re on 5ecember %7, %77* at
around #"(7 /.6.)
%. $hat said &re burned the whole Regional !3ce = building,
including its o3ce records, assets, properties and
accountabilities)

(. $hat we have personal @nowledge of the foregoing incident,
having actually witnessed the same)

*. $hat the foregoing is e+ecuted for the purpose of securing the
granting of relief from accountability of the 5I'2 Region =, its
management and personnel by the Commission on /udit and
for whatever other legal purposes this may serve.
F,R$-.R, <. S/0.$- 1/,2-$.
'ILLIAM C. (ALER) CESO IV 'ILLIAM C. (ALER) CESO
IV
/3ant /3ant

Subscribed and sworn before me, this 4444 day of Aune, at
$acloban City,
a3ants e+hibiting to me their Residence Certi&cate 1os. as above
indicated.
1otary Public
5ocument 1o.
Page 1o.
oo@ 1o.
Series of %77;

Anda mungkin juga menyukai