REPUBLIC OF THE PHILIPPINES )

Province of ) S.S.
City of )
x------------------------------------------------x

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, _______ and, _______ both Filipinos, of legal ages, and both
residents of Agsam, Lanuza, Surigao del Sur, having been duly
sworn in accordance with law, hereby depose and state:

1. That we have personally known the person of ______ for a

long period of time having been a longtime friend and living
within the same barangay;

2. That we know for a fact that she has been using the name
____ in some of the documents.

3. That in her Certificate of Live Birth, her name is "_____."

4. That ___ is the same person as ____ registered as a

member of Social Security System with SSS Number 33-
1234567-0.

5. That although registered as ____, her true and correct name

is ____.;

3. As such, we execute this Affidavit to attest to the truth of the

foregoing facts and for whatever legal purpose that this Affidavit
may serve.

IN WITNESS WHEREOF, we have set our hands this September

___, 2017, in Tandag City, Surigao del Sur, Philippines.

__________ __________
Affiant Affiant

SUBSCRIBED AND SWORN to before me this ___ day of September, 2017 in

the province of _______, affiants personally appeared exhibiting to me the
above-mentioned competent evidence of identity.

1
 NOTARY PUBLIC

Doc. No.: ____;

Page No.: ____;
Book No.: ____;
Series of 2017.