REPUBLIC OF THE PHILIPPINES )

QUEZON CITY ) S.S

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, APN, Filipino, of legal age, married and a resident of ________ a resident of 125
Area 5, Sitio Mendez, Baisa, Quezon City, after having been duly sworn to in accordance
with law, hereby depose and state, that:

1. We personally know MPO, a member of the Social

Security System with SSS No. _______ He was born on February 27, 1965 in
Catungahan, Bohol. A copy of his Certificate of Live Birth is hereto attached as
ANNEX “A” hereof;
2. The reason we personally know him is that we have been neighbors and
friends for almost eighteen (18) years now;
3. By virtue of our close association with NPO, we can attest to the fact that
since Grade 1, he has consistently used the name NPO and has been known as
such in all his school and other records;
4. Accordingly, when he applied for membership with the Social Security Sytem
(SSS) sometime in 1983 through Personal Data Form (E1), he declared in good
faith his name as NPO. Actually, his middle name and surname are that of his
mother’s.
5. It was only when he secured his Certificate of Live Birth from the Philippine
Statistics Authority (formerly National Statistics Office) and his Philippine
Passport from the Department of Foreign Affair (DFA)-Manila that he learned
for the first time that his true and correct name is NPO.
6. To be candid, Nestor was born out of wedlock thus, illegitimate at the time of
his birth. In addition, his parents, FPO and FPO, never cohabited or lived
together;
7. That the names, “NPO” (as appearing in his SSS Records) and “NPA (per his
Certificate of Live Birth), both refer to one and the same person, the latter
being his correct and true name.

That we are executing the foregoing Joint Affidavit in order to attest to the truth that
the names, NPO, as per his records with the SSS and NPA per his Certificate of Live Birth,
refer to one and the same person, the latter being his true and correct name in support of his
request for the omission of his middle name and for the issuance of a Unified Multi-Purpose
Identification (UMID) Card with the SSS and for whatever legal purpose this may serve.

Further affiants sayeth none.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this 24 th day of

May 2017 in Quezon City.

APN RAO
Affiant Affiant
Philippine Passport ID No. EC1994046 ID No. 137404005-9439-00070
Issued on Aug. 29, 2014 Issued by DSWD

1
 SUBSCRIBED AND SWORN TO before me, a Notary Public for and in Quezon
City, this 24th day of May 2017, affiants having exhibited their respective identification
cards, the details of which are stated above.

Witness my hand and seal on the date and place written above.

Doc. No.________}
Page No.________}
Book No. _______}
Series of 2017