REPUBLIC OF THE PHILIPPINES

)
MUNICIPALITY OF _______
) S.S.
x-----------------------------------------------x

JOINT AFFIDAVIT OF COHABITATION

WE, JOHNNY and AILEN, both of legal age, Filipino, single (living
together) and residents of ________________, after having been duly sworn to
in accordance with law, depose and state THAT:
I.
We have been living together as husband and wife under the same
roof, continuously and without any interruption, since the year 2010 or a
period of more than five (5) years;
II.
During our cohabitation and even until the present, we remain both
of single status and, hence, there exists no legal impediment for us to
marry each other;
III.
We are executing this affidavit to attest to the foregoing facts and for
the purposes of contracting marriage without the need of securing
the marriage license pursuant to the provisions of Article 34 of the Family
Code of the Philippines.

IN WITNESS WHEREOF, we have hereunto set our hands this 15th day
of December, 2015 in __________, Philippines.

JOHNNY
Affiant

AILEN
Affiant

SUBCRIBED AND SWORN TO before me this 15th day of December,

2015 in ____________, Philippines, affiants exhibiting to me their valid proofs
of identification.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2015.