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Republic of the Philippines)

:
In the City of Pagadian…….)S.s.
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AFFIDAVIT OF TWO DISINTERESTED PERSON


(Re: Correction of Entry)

We, ILIBAR L. GREGORIO and JERRY DE GUZMAN, Filipinos, both of legal age,
married respectively and are residents of Poblacion, Bayog, Zamboanga del Sur, after having
duly sworn to in accordance with law, do hereby depose and say;

That we personally knew MARY LUZ YBAÑEZ DIAZ, because we are closed family
friends;

That Mary Luz Y. Diaz, is a bona fide resident of Barangay Kahayagan, Bayog,
Zamboanga del Sur, as evidenced by Certification issued by the Punong Barangay of Barangay
Kahayagan, Bayog, copy hereto attached forming an integral part of this affidavit;

That however, as appeared in her per hospital records, her address was erroneously
entered at Barangay Santo Niño, Pagadian City, when in truth and in fact, she is a bona fide
resident of Barangay Kahayagan, Bayog, Zamboanga del Sur;

That this erroneous entry if not corrected in time will cause confusion as to her
personal, official and future transaction;

That we are not related to Mary Luz Y. Diaz, either by consanguinity or by affinity;

That we are executing to attest to the truth of the foregoing statement that to support
for the correction of entry of Mary Luz Y. Diaz, from Barangay Santo Niño, Pagadian City, to
Barangay Kahayagan, Bayog, Zamboanga del Sur;

IN WITNESS WHEREOF, we have hereunto affix our respective signature this 11 th day
of December 23017, at Pagadian City, Zamboanga del Sur, Philippines.

ILIBAR L. GREGORIO JERRY DE GUZMAN


Affiant Affiant

SUBSCRIBED AND SWORN to before me this 11 th day of December 2017, at


Pagadian City, Zamboanga del Sur, Philippines.

DOC. NO.
PAGE NO.
BOOK NO.
SERIES OF 2017