Republic of the Philippines}

City of Davao } S.S

x--------------------------------------x

AFFIDAVIT OF DELAYED REGISTRATION

OF BIRTH

I, JILL RATERTA LOTTER, of legal age, widow, Filipino Citizen and

residence of Tibungco, Davao City, Philippines, after having been duly sworn
in accordance with law, hereby depose and say that:

1. That in my son for delayed registration of birth of PHILIPP

FREDERICO LUDWIG RATERTA LOTTER;
2. That the date of birth and place of birth of my son PHILIPP
FREDERICO LUDWIG RATERTA LOTTER was born on
September 04, 1995 in KOLN GERMANY;
3. That due to the negligence and/or inadvertence on my part and the
prevailing conditions then, his birth was not reported and registered
with the Office of Department of Foreign Affairs (DFA) Davao City,
Philippines;
4. That I am executing this affidavit to attest to the truth of the foregoing
facts and to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

July 5, 2023 in the City of Davao Philippines.

JILL RATERTA LOTTER

Affiant

SUBSCRIBED AND SWORN to before me this July 5, 2023 in

Davao City, Affiant personally appeared and showing to me her Philippine
Passport No.P9162963A issued on October 12, 2018 in DFA Davao.

Doc No.____;
Page No.____;
Book No.03;
Series of 2023.