REPUBLIC OF THE PHILIPPINES)

IROSIN, SORSOGON ) s.s.

JOINT SUPPLEMENTAL MINORITY

WE, ________________________ and ______________________________, married,

both of legal age, Filipinos, and residents of Calayuan, Matnog, Sorsogon after
having been sworn to in accordance with law, hereby depose and state:

1. That we are the biological parents of _________________;

2. That ______________________ was born on ________________;

3. That at the time of the conception and birth of ________________ I

_______________________ is only ___ years old and I __________________ is only
___, years of age;

4. That we could not have contracted marriage at that time prior to the birth
of our son due to our age, specially ___________ age who is then considered
as still a minor;

5. That eventually though, we have contracted marriage on

_______________________ at ___________________;

That we are executing this affidavit to attest to the foregoing facts the
foregoing facts and for whatever purpose this may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this

___________________________, at Irosin, Sorsogon.

_______________________ ____________________________
Affiant Affiant

SUBSCRIBED AND SWORN to before me in Irosin, Sorsogon, this

________________.