AFFIDAVIT AS TO MINORITY

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF _______________ )S.S
x-------------------------------------------x

I, ___________________, who was born on August 4, 1976, Filipino,

of legal age, with residence and postal address at ______________________,
married to _________________ on January 17, 2020, after being duly sworn
to in accordance with law hereby depose and say:

That I am the biological mother of _____________________, who was

born on June 21, 1994 at ________________________, and which fact of birth
was duly recorded with the Office of the Local Civil Registrar of
____________________;

However, at the time of his (_________________) conception, I,

_________________ was only FIFTEEN (15) year old, thus still a minor
when he was conceived;

That I am executing this affidavit to attest to the truth and veracity of the
foregoing facts and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, we have hereto affixed our signatures this

_____________________ at Kalibo, Aklan, Philippines.

________________________
Affiant
VIN 0415-0026A-D0679MDR20000
__________________________

SUBSCRIBED AND SWORN to before me this

____________________ at ___________________ by above-named affiant
_____________________ who have both personally came and who have
satisfactorily proven to me her identity through her Valid ID card indicated
above below her name and known to me to be the same person who personally
signed the foregoing Affidavit before me and acknowledged that she executed
the same.

Doc. No.______;
Page No.______;
Book No.______;
Series of 2019.
 AFFIDAVIT OF SUPPLEMENTAL REPORT
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF AKLAN ) S.S.
MUNICIPALITY OF KALIBO )
X--------------------X

That I, JOHN REMMEL DIZON ROGA, minor, single, Filipino, and a

resident of Barangay Cawayan, New Washington, Aklan, Philippines, after being
duly sworn, hereby depose and say:

That I am the son of Spouses MELISSA T. DIZON and REMY P. ROGA,

born on June 21, 1994 at Cawayan, New Washington, Aklan;

That the fact of my birth was duly recorded with the Office of the Civil
Registrar of New Washinton, Aklan;

That when I secured a copy of my Certificate of Live Birth from the Philippine
Statistics Authority (PSA), I found out that there was no entry in my middle name;
as well as DIZON entered as my last name;

That my correct middle name is DIZON, as well as my correct last name is

ROGA; hence my correct full name is JOHN REMMEL DIZON ROGA;

That the failure to state my middle name and correct last name was due to
the situation that during my birth, my parents were still minors at that time;

That I am executing this affidavit to attest to the truth of the foregoing facts
for all legal purposes and to supplement the missing entries in my Certificate of
Live Birth and to request the Philippine Statistics Authority (PSA), to enter in the
Certificate of Live Birth my correct full name as JOHN REMMEL DIZON ROGA;

IN WITNESS WHEREOF, I have hereto affixed my signature this

______________ at Kalibo, Aklan.

JOHN REMMEL DIZON ROGA

Affiant
ID No._____________________________
Place/Date of issue:___________________

SUBSCRIBED AND SWORN to before me this ___________________ at

Kalibo, Aklan, affiant exhibiting to me his identity stated below his name.

Doc. No. ____

Page No. ____
Book No. ___
Series of 2019.