Republic of the Philippines

Municipality of Palo
Province of Leyte
} S.S.

AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, ERLINDA N. ROYO and LUCRESIA N. GERONES, both of legal ages,

widows, Filipinos, with residence and postal address at Brgy. Arado and Cavite
West, Palo, Leyte, respectively, after having been sworn to in accordance with law
hereby depose and state the following, THAT:

1. WE are friends of the OBINA-ROCA family of Palo, Leyte

having been a close friend of the said family and had always
been present in social gatherings and other communal
affairs. As such we are familiar and know the persons,
members of the family of OBINA-ROCA, relatives, dates of
important events of the aforementioned family;

2. We likewise know that ISABEL OBINA-ROCA died on

NOVEMBER 15, 1989 at Palo, Leyte;

3. Such death of ISABEL was not recorded/registered with

the Municipal Civil Registrar of Palo due to unawareness of
civil registration laws, rules and regulation;

4. WE are executing this affidavit to attest the truth of the

foregoing information and for the delayed registration of
death of ISABEL OBINA-ROCA with the Office of the
Municipal Civil Registrar, Palo, Leyte and the Philippine
Statistics Office (PSA).

IN WITNESS WHEREOF, We hereunto set our signatures this

___________________ at the Municipality of Palo, Leyte, Philippines.

ERLINDA N. ROYO LUCRESIA N. GERONES

Affiant Affiant
OSCA Control No. 0332 OSCA Control No. 0067

SUBSCRIBED AND SWORN to before me, NOTARY PUBLIC for and in the above
jurisdiction, this ___________________ at the Municipality of Palo, Leyte, affiants exhibited their
Senior Citizen’s identification card as competent proof of their identities.

Doc. No. __
Page No. ____
Book No. ___
Series of 2021