Republic of the Philippines

Province of Leyte S.S.

Municipality of ____________

AFFIDAVIT FOR DELAYED REGISTRATION OF MARRIAGE

We, ROLANDO B. FABI and NELIA T. FABI, of legal age, Filipino, married to
each other and with residence address at Brgy. Sto. Nińo, Jaro, Leyte, under oath,
hereby state:

1. That we got married on 25 January 1989 at St. Matthew The Apostle and
Evangelist Parish, Jaro, Leyte;

2. That our marriage was solemnized by Rev. Fr. Benedicto B. Catilogo and was
witnessed by Rufo C. Ribo, Zenaida Arguilles, Berdan Molabola and Filomena
Rocaberte;

3. That last 13 October 2022, our son, Ruel T. Fabi went to the Philippine Statistics
Office (PSA) Tacloban for the purpose of securing a copy of our Marriage
Certificate as he will be using the same for his job application in the Philippine
Army. However, no Marriage Certificate was released to him, instead, a
certification was issued stating that the Philippine Statistics Office has no record
of our marriage;

4. That our marriage was not registered with the Office of the Civil Registry of the
Municipality of Jaro because of the inadvertence and/or failure of the persons
responsible for its registration;

5. That we are executing this Affidavit to attest to the truth of the foregoing facts
and to support our application for the delayed registration of our marriage before
the Office of the Civil Registry of Jaro and the Philippine Statistics Office.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this

____________________ in _________________, Philippines.

ROLANDO B. FABI NELIA T. FABI

Affiant Affiant
Valid ID: __________________ Valid ID: __________________

SUBSCRIBED AND SWORN to before me this ____________________.

Affiants exhibited to me their Identification Cards above indicated as competent
evidence of identity.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______.