REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF ILAGAN )S.c.

PROVINCE OF ISABELA )

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

RE: LATE REGISTRATION OF BIRTH

We, _____________________________ and _______________________,

both of legal ages, Filipinos, and residents of Brgu. Alibagu and Brgy.
Osmeña, City of Ilagan, Isabela, after having been sworn in accordance
with the law hereby depose and state that:

1. We personally know the facts and circumstances surrounding the

birth of the person of _____________________ who was born to
spouses ______________________ and _____________________
who was born on ___________________ in Alibagu, City of Ilagan,
Isabela;

2. The birth certificate of ______________________was not

immediately registered with the Office of the City Registrar,
primarily because of the inadvertence of the parents or failure of
the person delegated to do so, hence, this Joint Affidavit;

3. That the birth certificate of the said child is not registered with any
Office of the Local/Municipal/City Civil Registrar;

4. We are not in any way related to any of the foregoing person

within the fourth civil degree either by consanguinity or affinity,
nor do we have any pecuniary interest in this matter whatsoever;

5. We are executing this affidavit to attest to the truthfulness of the

foregoing statements and to establish that the facts of birth of
___________________ has not been registered in the Local Civil
Registry of the City of Ilagan, Isabela for all legal intents and
purposes it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this 24 th

day of October 2023 at the City of Ilagan, Isabela.

______________________________ ___________________________

Affiant Affiant
 SUBSCRIBED AND SWORN TO before me this 24th day of October
2023 at City of Ilagan, Isabela.

ATTY. MARY GRACE M. CAMMAYO-GAOIRAN

Public Attorney II
Administering Oath
Pursuant to RA 9406