Affidavit of Disinterested Persons

REPUBLIC OF THE PHILIPPINES

CITY OF URDANETA } S.S.

AFFIDAVIT OF
DISCREPANCY/DISINTERESTED PERSONS
We, EPIFANIA F. LAGUNA and FRANCISCA M. LABARINTO, both of
legal age, both Filipino citizens, widowed, respectively, and both residents of Brgy.
Nancamaliran West, Urdaneta City, Pangasinan, after having sworn to in accordance in
law, hereby, depose and state that:

1. We are the neighbors of GLORIA L. BALTAZAR (hereinafter referred to as

“Gloria”), of legal age, Filipino citizen, widowed, and a resident of Brgy. Nancamaliran
West, Urdaneta, Pangasinan;

2. Gloria is the widowed spouse of Abad F. Baltazar, Jr. who died intestate on 24
February 2020;

3. Gloria is now processing the claims and/or benefits pertaining to the death of
Abad F. Baltazar, Jr.;

4. In the course of the claims, it was discovered that there were several
discrepancies in the documents and certificates presented by Gloria before the
government agencies, instrumentalities, and/or offices, specifically:
a. On the Birth Certificate of Eric L. Baltazar, the date of marriage of his
parents Gloria and Abad is recorded as 4/27/1987, but it should be
corrected as 4/28/1986;
b. On the Birth Certificate of Khin Yvette L. Baltazar, the name of the father is
registered as “ABAD F. BALTAZAR”, which should be corrected as “ABAD
F. BALTAZAR, JR”;
c. On the Birth Certificate of Jay L. Baltazar, the name of the father is
registered as “ABAD F. BALTAZAR”, which should be corrected as “ABAD
F. BALTAZAR, JR); and the date of marriage is recorded as 4/29/1988, but
it should be corrected as 4/28/1986;
d. On the Birth Certificate of Jerick L. Baltazar, the name of the father is
registered as “ABAD F. BALTAZAR”, which should be corrected as “ABAD
F. BALTAZAR, JR”;

5. We personally know that Abad, Gloria, Eric, Khin Yvette, and Jerick from the
day that they were born;

6. We personally know that Abad, Gloria, Eric, Khin Yvette, and Jerick from the
time that we were little children;

7. We personally know that Abad, Gloria, Eric, Khin Yvette, and Jerick all of
whom had been living within our barangay since we came of age and reason;

8. We understand that Gloria is currently processing the claims and/or benefits

pertaining to the death of Abad, but the government agencies, instrumentalities, and/or
offices requires an affidavit attesting and clarifying the facts stated above by two
disinterested persons;

9. We attest to the fact that the name of the father of Khin Yvette L. Baltazar, Jay
L. Baltazar, and Jerick L. Baltazar is “ABAD F. BALTAZAR, JR”; and that the date of
marriage of Gloria and Abad is 4/28/1986; and
 Affidavit of Disinterested Persons

10. In compliance with the abovementioned requirement, we are executing this

affidavit to attest to the veracity of the foregoing facts and for whatever legal purpose it
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this ____ day
of July 2020 at the City of Urdaneta.

__________________________ ____________________________
EPIFANIA F. LAGUNA FRANCISCA M. LABARINTO
Co-affiant Co-affiant

SIGNED IN THE PRESENCE OF:

___________________________ ___________________________
Witness Witness

SUBSCRIBED AND SWORN to before me on the date and place first above
written, affiant presenting to me, as competent proof of their identity the following:
Names ID
EPIFANIA F. LAGUNA Senior Citizen ID 2162
FRANCISCA M. LABARINTO Senior Citizen ID 03347

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