REPUBLIC OF THE PHILIPPINES)

VALENZUELA CITY                    ) SS.

AFFIDAVIT OF CIVIL STATUS

I, JUAN PEDRO PENDUKO , of legal age, married, and with residential
address at 708-CDE Landmark Villa 1 Kaimito St. Valle Verde 2, Pasig City, after
having been sworn to in accordance with law do hereby depose and say that:

1. I was born on October 20, 19___. A copy of my birth certificate is hereto
attached as ANNEX “A”;

2. My civil status is ‘MARRIED’.

3. I am married to ___________________. A copy of my marriage certificate is

attached herein as ANNEX B.

3. I am executing this Affidavit to attest to the truth of the foregoing facts and
to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this_____ day of

September 2020 at Valenzuela City.                        
                        

JUAN PEDRO PENDUKO 

 Affiant
                                                               Driver’s License I.D. No.

SUBSCRIBED AND SWORN before me this ___ day of September 2020 at

Valenzuela City, affiant showing me his valid ID stated below his name bearing his
photograph and signature.

Notary Public

Doc No. ________;

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