REPUBLIC OF THE PHILIPPINES )

CAMILING, TARLAC ) S.S.

JOINT AFFIDAVIT
OF TWO DISINTERESTED PERSONS

We, JUAN, and JUANA, both of legal ages, Filipino citizens and
residents of Barangay, after having been duly sworn to in accordance
with law, do hereby depose and state THAT:

1. We both personally know UNO (Uno, for brevity), who was born
on June 18, 1957 to Spouses Pedro Navarro and Etilia Fernandez
in Camiling, Tarlac;

2. Lately, Uno went to the SSS of the Philippines (SSS), to file for
his Retirement claim benefits;

3. He was required to submit among others, copies of his Baptismal

Certificate, Certificate of Marriage and Live Birth of Uno;
However, upon verification of the records of Uno particularly in
his RS1 file with the SSS, it was discovered that her mother’s
name was recorded as TRES instead of KUWATRO, hence the
discrepancy;

4. We are not related to UNO either by consanguinity or affinity,

except that of being his acquaintance;

5. We are executing this affidavit to attest to the fact that the

names TRES, as the mother of UNO appearing in the said
Certificate of Live Birth, Certificate of MarriageS and Baptismal
Certificate, and KUWATRO appearing as the mother of UNO in
the said RS1 as recorded in his SSS file, refer to one and the
same person, and that is the mother of our acquaintance UNO;

6. Finally, we are executing this Affidavit to attest to the truth of

the foregoing statements and for all legal intents and purposes it
may serve.

IN WITNESS WHEREOF, we have hereunto affixed our

signatures this 119th day of DEcember, 1969 at Philippines.
 JUAN JUANA
Affiant Affiant
Senior Citizen ID Card Senior Citizen ID Card

SUBSCRIBED AND SWORN to before me on the date and place

indicated above. Affiants exhibited before me their respective
competent evidence of identity indicated below their names.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 1969.