REPUBLIC OF THE PHILIPPINES)

Province of ____________________) S.S.

City/Municipality of _____________)
x - - - - - - - - - - - - - - - - - - - - - - - x

JOINT AFFIDAVIT

We, _____________ and _____________, both of legal ages, Filipinos, and residents of
_____________ and _____________, respectively, after having been duly sworn to in
accordance with law, do hereby depose and state the following:

That we are Barangay Officials of the aforementioned Barangay being the
_____________ and _____________, respectively.

That we know the person of _____________ because he was a resident of the
aforementioned Barangay of which we are officials;

That we know for a fact the said _____________ died on _____________ at
_____________ due to _____________;

That we are executing this affidavit to attest to the truthfulness of the fact of death of the
person of _____________ and for whatever legal purposes that this statement may
serve.

IN WITNESS WHEREOF, we have hereunto set our hands this _____________, in the
City of _____________, Philippines.




AFFIANT AFFIANT



(JURAT)