AFFIDAVIT OF NON-COHABITATION

I, DIANA MAE P. SUPREMIDO, of legal age, Filipino, married and resident of #18 Alonzo
Street Phase3A Bahayang Pagasa Subdivison Brgy. Mariano Espeleta 1 Imus, Cavite,
after having been duly sworn in accordance with law hereby depose and state that:

1. I am currently married to Justin Jay D. Supremido;

2. We have one child, Jared Troy P. Supremido who was born on July 31, 2014 in Las Piñas
City;
3. However, the above stated person and I have been separated for almost 5 years and both
of us have no plans to reconcile now neither soon.
4. The purpose of the execution of this affidavit is to affirm the facts alleged herein and for
whatever legal purpose it may serve.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day of May 2021 in Cavite,
Philippines.

DIANA MAE P. SUPREMIDO

Affiant

SUBSCRIBE AND SWORN TO, before me this 20 May 2021, in Cavite, Philippines,
affiant exhibiting to me his Driver’s License with ID No. N02-11007078, bearing her picture
and signature.

WITNESS MY HAND AND NOTARIAL SEAL on ___________________ in Cavite.

Notary Public