Republic of the Philippines )

Dumaguete City ) S.S.

x------------------------------------x

JOINT AFFIDAVIT OF COHABITATION

WE, CATHERINE TEMONIO ROYO and JOHN S. LAKE, both of legal age, single
(living together), Filipinos and residents of Bajumpandan, Dumaguete City, after having been
duly sworn to in accordance with law, do hereby depose and state, THAT:

1. We have been living together as husband and wife under the same roof, continuously and
without interruption, since 2015, or a period of six (6) years;

2. During our cohabitation and even until the present, we remain both of single status;
hence, there exists no legal impediment for us to marry each other;

3. We were blessed with one son named KHYLLE JOHNCEN R. LAKE, who was born
on October 27, 2016;

4. We are executing this Affidavit to attest to the truth of the foregoing facts and for the
purposes of contracting marriage without the need of securing the marriage license
pursuant to the provisions Article 34 of the Family Code of the Philippines.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
__________________ in Dumaguete City.

CATHERINE T. ROYO JOHN S. LAKE

Affiant Affiant
Proof of Identity: COMELEC Proof of Identity: PAG-IBIG
I.D. No.: VIN: 4610-0073A-G1589CTR20000 I.D. No.: 1212-1008-0375

SUBSCRIBED AND SWORN TO BEFORE ME, this ____________ in Dumaguete City,

Philippines, Affiants exhibiting to me their proof of identity as indicated below their names.

Doc. No._____
Page No.____
Book No. ____
Series 2021.