Republic of the Philippines )

Province of La Union )
Municipality of Aringay )S.S.
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AFFIDAVIT OF LATE REGISTRARION

I, MARIBEL SORIANO, of legal age, Filipino citizen, and a resident of

Brgy. Poblacion, Aringay, La Union, after first being duly sworn to on oath in
accordance with law, hereby depose and state:

That I was born to Spouses FLORENCIO C. FLORES and MARIETA D.

FELIPE on February 8, 1972 in Davao City, Davao Del Sur;

That sometime in 2012, when I tried to register with the Social Security
System (SSS), one of the requirements is the submission of a Certificate of Live
Birth. I tried to obtain a copy of my Certificate of Live Birth from the National
Statistics Office (now Philippine Statistics Authority), but I discovered that the fact
of my birth was not registered with the local civil registrar of Davao City, Davao
Del Sur.

That I asked my mother of the reason why they were not able to cause the
registration of my birth, but she was also clueless, as she thought that the
doctor/midwife who attended to her had communicated with my father as to the
registration of my birth;

A copy of the Certification from the Philippine Statistics Authority,

certifying that they do not have any record of my birth, is hereto attached as Annex
“A”;

That I am executing this affidavit to attest to the truthfulness of the above-

narrated facts and to support the late registration of Certificate of Birth with the
Office of the Local Civil Registrar and Philippine Statistics Authority, and for all
legal intents and purposes it may serve.

IN WITNESS WHEREOF, I hereby affix my signature this __day of

October 20__ at Aringay, La Union.

MARIBEL SORIANO
Phil.Sys ID No. 12345678910111213
Issued on July 13, 2022
(with picture)

SUBSCRIBED AND SWORN TO before me this __ day of October 2022 at

Aringay, La Union, affiant having personally appeared before me and exhibiting to
me her PhilSys Identification Card, the particulars of which are herein-indicated
below her name, which I consider as competent evidence of her identity.