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Republic of the Philippines )

Camiling, Tarlac ) S.S.

JOINT AFFIDAVIT
OF TWO DISINTERESTED PERSON

WE, REMEDIOS D. DACAYANAN, of legal age, Filipino citizen


and a resident of Barangay Sta. Maria, Camiling, Tarlac, and
RUBENITA D. QUIMABAO, of legal age, Filipino citizen and a
resident of Barangay Sta. Maria, Camiling, Tarlac, after having been
duly sworn to in accordance with law, do hereby depose and state
THAT:

1. We both personally know NESTOR JOSE DOMINGO (Nestor,


for brevity), born on September 3, 1956 to Spouses Eustaquio
Silvestre Domingo and Victorina Tumbaga Jose in Camiling,
Tarlac;

2. Nestor is a member of the Social Security System of the


Philippines (SSS) until his death on April 21, 2017;

3. Lately when Hilda Dela Cruz filed for the Burial and Death
Claim Benefit of her late husband before the SSS Camiling,
Tarlac branch, she was required to submit, among others,
copies of Nestors Certificates of Live Birth and Death including
their Marriage Contract;

4. After securing the required documents and upon processing, it


was discovered that the recorded First Name of Nestors
mother appearing in his Marriage Contract and Certificate of
Death is VICTORIANA, instead of VICTORINA as appearing
in his Certificate of Live Birth; hence, the discrepancies;

5. We are not related, either by consanguinity or affinity, to


Nestor, except that of being his friends;

6. We are executing this Affidavit to attest to the fact that the


names VICTORINA TUMBAGA JOSE, appearing as the
mother of Nestor Jose Domingo in Nestors Certificate of Live
Birth, and VICTORIANA JOSE, appearing as the mother of
Nestor Jose Domingo in the above-stated Marriage Contract
and Certificate of Death, refer to one and the same person,
and that is the mother of our friend Nestor;

7. Finally, we are executing this Affidavit to attest to the truth of


the foregoing statements and for all legal intents and purposes
it may serve.

IN WITNESS WHEREOF, we have hereunto affixed our


signatures this 20th day of June, 2017 at Camiling, Tarlac,
Philippines.

REMEDIOS D. DACAYANAN RUBENITA D. QUIMABAO


Affiant Affiant
Employment ID Card Employment ID Card
Employee No.: CML-097 Employee No.: CML-103
LGU-Camiling, Tarlac LGU-Camiling, Tarlac

SUBSCRIBED AND SWORN to before me on the date and


place indicated above. Affiants exhibited to me their competent
evidence of identity indicated below their names.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2017.