Republic of the Philippines)

Province of Aklan ) S.S.

X ------------------------------x

JOINT AFFIDAVIT FOR LATE REGISTRATION

(Two Disinterested Persons)

WE, ______________ and _____________, all of legal age, married and

residents of ________________, Philippines, after having been sworn to in
accordance with law, hereby jointly depose and state:

That we personally know ______________ who was born on

_____________ Spouses ___________________ in _______________;

That the fact of birth of ____________________ as above-stated was not

yet registered with the Office of the Local Civil Registrar of _________ due
to inadvertence and negligence and without fault on her parents;

That we are not interested whatsoever in any transactions that

__________ has entered or to be entered by him in the future and we are
executing this Joint Affidavit in order that her fact of birth may be
registered with the Local Civil Registrar of _________ and to attest to the
truth of the foregoing facts.

IN WITNESS WHEREOF, we hereunto set our hands this ___ day of

________, at _________, Philippines;

_____________________ _________________________
Affiant Affiant
Senior Citizen ID No. _____ Senior Citizen ID No. ______

SUBSCRIBED AND SWORN to before me this __ day of _____ at

_______, Philippines. Affiants personally appeared and their identities
confirmed with their Valid Identification Cards as above indicated.

Doc. No. ________;

Page No. ________;
Book No. _______;
Series of 2020.