I, of Legal Age, Filipino, Single and A Resident of 177

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REPUBLIC OF THE PHILIPPINES)

Province of Iloilo) S.S.


City of Iloilo)
x-----------------------x

AFFIDAVIT

I , of legal age, Filipino, single and a resident of 177 PHHC


Road, Q. Abeto St. Mandurriao, Iloilo City, having been duly sworn in accordance with law,
hereby depose and state:

1. That I have personally known the person of for a long


period of time;

2. That I know for a fact that the person by the name of "
" appearing in some documents and records or specifically in his SPA Birth
Certificate of Registration No. 46543252 issued on July 11, 2000 and the name "
" as appearing in the record of
local Birth Certificate in Municipality of Roxas City, refer to one and the same
person and that his true and correct name is ;

3. As such, I execute this Affidavit to certify or attest to the truth of the foregoing
facts and for whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, I have set my hands this _____________, at _____________,


Philippines.

RODELO B. IBASCO
AFFIANT

SUBSCRIBED AND SWORN to before me, this _____________, by the Affiant who is
personally known to me.

NOTARY PUBLIC

Doc. No. ______;


Page No. ______;
Book No.______;
Series of 20____.

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