Republic of the Philippines)

Province of Surigao del Sur) s.s.

Municipality of Tago)
x------------------------------------/

JOINT AFFIDAVIT OF DELAYED REGISTRATION

OF BIRTH BY TWO DISINTERESTED PERSONS

WE, EVELYN CAPESOS and ELIZABETH SALISI, both Filipinos,

of legal age and residents of Barangay Unidad, Cagwait Surigao del Sur,
Safter having been duly sworn to in accordance with law, depose and
state:

1. That we personally know RAYSA MAE ORITO ILIGAN, she

being our neighbor;

2. That we have personal knowledge that RAYSA MAE ORITO

ILIGAN was born on October 17, 2013 to spouses REBECCA APORBO
ORITO and ERIC CASAS ILIGAN at Brgy. Unidad, Cagwait Surigao del
Sur;

3. That the birth of RAYSA MAE ORITO ILIGAN was attended

to by a local hilot, of Brgy. Unidad, Cagwait, Surigao del Sur;

4. That the said birth was not registered within thirty (30) days
therefrom with the Local Civil Registrar of Cagwait, Surigao del Sur due to
the negligence of the said hilot and to date, it remains unregistered; and

5. That we are executing this Affidavit to attest the veracity of

the foregoing and in compliance with the requirements of the Local Civil
Registrar of the Municipality of Cagwait, Surigao del Sur, relative to the
application for delayed registration of the birth of RAYSA MAE ORITO
ILIGAN and for other legal purposes.

IN WITNESS WHEREOF, we affix hereunto our signatures this 17 th

day of January, 2020 at Tago, Surigao del Sur, Philippines.

EVELYN CAPESOS ELIZABETH SALISI

Affiant Affiant

SUBSCRIBED AND SWORN TO before me this 17th day of

January, 2020 at Tago, Surigao del Sur, Philippines. Affiants exhibited to
me their competent evidence of identities.

Doc No. ___

Page No. ___
Book No. I
Series of 2020