Republic of the Philippines)

Province of Southern Leyte…) S.S

Municipality of Macrohon)

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

(Late Registration of Birth)

We, NORMA R. VALLES and DOLORES P. PEREZ, both of legal age,

Filipino, married and residents of Sta Sofia, Padre Burgos, Southern Leyte,
after having been duly sworn to in accordance with law, do hereby depose and
state;

1. That we personally know the person of NAZARIO BARCELON ACLAO of

Padre Burgos, Southern Leyte;

2. That she was born on November October 11, 1945 at Sta Sofia, Padre
Burgos Southern Leyte;

3. That upon verification at the Philippine Statistics Authority (PSA) and

Local Civil Registrar of Malitbog/Padre Burgos, Southern Leyte, we
discovered that the fact of her birth was not yet registered;

4. That the reason for the delay in registering the birth of NAZARIO
BARCELON ACLAO with the Office of the Local Civil Registrar at
Malitbog/Padre Burgos, Southern Leyte and Philippine Statistics Authority
due to an excusable negligence on the part of the parents;

5. That we know the fact of the above-named person because we are close
friends of their family;

6. That we are not related to them within the fourth civil degree, either by
affinity or consanguinity;

7. That we executed this affidavit freely and voluntarily in order to attest to

the truth and veracity of the foregoing in order to support for the late
registration of NAZARIO BARCELON ACLAO whatever legal intents and
purposes this may serve.

IN WITNESS WHEREOF, we have hereunto set our hand this

____________________ in the Municipality of Macrohon, Southern Leyte,
Philippines.

NORMA R. VALLES DOLORES P. PEREZ

Affiant Affiant
Senior Citizen(Padre Burgos) ID No. 1150 Senior Citizen (Padre Burgos) ID
No. 1126
Issued on July 14, 2015 issued on May 26, 2015

SUBSCRIBED AND SWORN TO BEFORE ME, this ___________________at

Macrohon, Southern Leyte affiant exhibiting to me their ID as proof of his
identity.

ATTY. MENCHIE ANN S. SALINAS

Notary Public
Com. No. 2017-10 UNTIL Dec. 31, 2018
Roll of Attorneys No. 66790
Doc. No. ____ IBP No. 021495; 1/05/18; Pasig City
Page No. ____ PTR No. 6073809; 1/04/18; Maasin City
Book No. ____ Series of 2018 Macrohon, Southern Leyte