JOINT AFFIDAVIT OF ONE AND THE SAME PERSON

Republic of the Philippines )

) S.S.

We,___________________ and ______________________, both Filipinos, of legal ages, and

residents of __________________________________and
________________________________________________, respectively, having been duly sworn in
accordance with law, hereby depose and say that :

That we have personally known the late “ANACORITA MANGHUYOD-PALO”, for a long period of
time having been her ____________________;

That we know for a fact that the person by the name of "SOCORRO MALBAYOD" appearing in some
documents and records or specifically in their Transfer Certificate of Title (TCT) No. 21255,
“CORAZON DE PIO MANGHUYOD” appearing on Birth Certificate of her only child, Maricor M.
Palo, and the name "ANACORITA MANGHUYOD-PALO" as appearing in the record of the Marriage
Certificate with Marriage License No. 5098163 of the Local Civil Registry of San Mateo, Rizal and
Death Certificate of the Local Civil Registry of Libmanan, Camarines Sur, refers to one and the same
person and that her true and correct name is ANACORITA MANGHUYOD-PALO;

As such, we execute this Affidavit or attest to the truth of the foregoing facts and for whatever legal
purpose that this Affidavit may serve.

IN WITNESS WHEREOF, we have set our hands this__________, at __________, Philippines.

________________________________ __________________________________
AFFIANT AFFIANT

SIGNED IN THE PRESENCE OF:

________________________________ ________________________________

SUBSCRIBED AND SWORN to before me this day of ______________ in_____________,

by affiants exhibiting to me their government issued identification cards, as follows:

Date & Place Issued

Name Valid Government-Issued ID
Place Issued

NOTARY PUBLIC
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of _____.