Republic of the Philippines )
_____________________ ) s.s.
_____________________ )
AFFIDAVIT OF TWO DISINTERESTED PERSONS
We, _____________________ and _____________________, both of legal
ages, Filipinos and residents of _____________________ after having been
duly sworn to in accordance with law hereby depose and state:
1. That we personally know _____________________ who was born on
_____________________ in Palo, Leyte;
2. That he is the son of Sps. _____________________and
_____________________;
3. That however, his birth was not registered before the Local Civil
Registrar of Palo, Leyte;
4. That we are executing this affidavit to attest to the truth of the
foregoing statements, for the late registration of birth of
_____________________ and for whatever legal purpose this may
serve.
IN WITNESS WHEREOF, we have hereunto affixed our signatures
this __________________ in _____________________.
_____________________ _____________________
Affiant Affiant
SUBSCRIBED and SWORN to before me this __________________ in
_____________________.
Doc No.:
Page No.:
Book No.:
Series of 2018