Republic of the Philippines )
___________________ )
___________________ ) S. S.
AFFIDAVIT OF COMMON-LAW WIFE
I, _____________________, of legal age, single, Filipino, and a resident
of _________________________, after having been sworn to an oath in
accordance with law, hereby depose and state;
That I was the common-law wife of deceased
__________________________, a member of the Philippine Army, who died on
_________________________;
That we cohabited as common-law husband and wife from
_________________ until on ___________________, in
________________________________;
That during our cohabitation, we begot two (2) children namely:
________________________, who was born on __________________, and
___________________, who was born on ____________________; and
That said _____________________________ is the biological and
acknowledged father of the aforementioned two (2) children.
AFFIANT SAYETH NAUGHT.
That I am executing this affidavit to attest to the foregoing facts and for
whatever legal purpose this may serve.
IN WITNESS WHEREOF, I hereunto affix my signature this
___________________ at ___________________________, Philippines.
________________________
Affiant
SUBSCRIBED AND SWORN to before me this __________________ at
______________________, Philippines, affiant exhibited to me her Identification
Card with number written below her signature as competent evidence of her
identity.
Doc. No. _______;
Page No. ______;
Book No. ______;
Series of ______.