Republic of the Philippines ]

City of Tagbilaran ]

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, NORBERTO G. LUMANAS JR., Filipino, of legal age, married, and a resident of
Corella, Bohol and URSULA Q. DAPAR, Filipino, of legal age, married and a resident of Bilar,
Bohol, Philippines, after having been duly sworn to in accordance with law, do hereby depose
and say:

That we both personally know the person of NORA SAJULGA TEMARIO, who is the
mother of JONEL TIMARIO SUMAYAG, the latter being a bonafide member of the Philippine
Health Insurance Corporation (PHIC);

That in her Certificate of Live Birth of her son JONEL TIMARIO SUMAYAG, her name is
erroneously reflected therein as NORA SAJULGA TIMARIO instead of her true and real name
which is NORA SAJULGA TEMARIO as correctly reflected in her Certificate of Live BIRTH
issued by National Statistics Office, Manila Philippines;

That by virtue of this presents, we hereby attest that the names, NORA SAJULGA
TEMARIO as per her Certificate of Live Birth issued by National Statistics Office, Manila
Philippines and Certificate of Live Birth of her son, JONEL TIMARIO SUMAYAG issued by the
National Statistics Office, Manila Philippines both refer to one and the same person, i.e. NORA
SAJULGA TEMARIO, who is the mother of JONEL TIMARIO SUMAYAG, the latter being a
bonafide member of the Philippine Health Insurance Corporation (PHIC);

That we are not in a way related either by consanguinity or affinity to the said person and
neither are we interested in the outcome of this affidavit our purpose being merely to set the
records straight;

That we are executing this affidavit not for purposes of fraud but to prove the real name
of NORA SAJULGA TEMARIO and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this _______________ at

the City of Tagbilaran, Bohol, Philippines.

NORBERTO G. LUMANAS JR. URSULA Q. DAPAR

Affiant Affiant
VIN ID No. 1216-0057A-J2054NGL10000 VIN ID No. 1208-0017D-I2071UQD20000
Issued by Comelec Bilar Issued by Comelec Cortes

SUBSCRIBED AND SWORN to before me this ________________ at the City of

Tagbilaran, Bohol, Philippines. Affiants exhibited to me their competent proof of identity, written
below their names.