JOINT AFFIDAVIT - Late or Delayed Registration of Birth

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BATANGAS ) S.S.

CITY OF TANAUAN )

JOINT AFFIDAVIT

(Re: Late/Delayed Registration of Birth)

We, CAMILO SANGALANG ROXAS and LUZVIMINDA TANAP ROXAS, 40 and 35 years of age, respectively, both Filipino citizens and with residence and postal address at Caloocan, Talisay, Batangas, after having been duly sworn and oath in accordance with law hereby voluntarily depose and say:

1. That we know personally RAF JAN RAPOSAS ESTEBAN who was born on 25th of December 2014 at Daniel O. Mercado Medical Center, Tanauan City, Batangas, Batangas to the Spouses RAFAEL SALAZAR ESTEBAN and JANICE ROJAS RAPOSAS;

2. That due to the negligence and/or inadvertence on the part of his parents and the prevailing conditions then, his birth was not reported and registered with the Office of the Municipal Civil Registrar of Talisay, Batangas immediately thereafter;

3. That we have first hand knowledge of the foregoing facts because we together with our respective families, being their acquaintances and close family friends, were among those who first visited her and her mother on the day that she was born as is customary in the province;

4. That we are executing this Joint affidavit to attest to the truth of all the foregoing facts, in connection with the application for the late/delayed registration of birth of the said RAF JAN RAPOSAS ESTEBAN with the office of the Municipal Civil Registrar of Talisay, Batangas and for whatever legal purpose this may serve;

IN TRUTH WHEREOF, we have hereunto set our hands, this __________________ at Tanauan City, Batangas, Philippines.

CAMILO C. ROXAS LUZVIMINDA T. ROXAS

Affiant Affiant

SUBSCRIBED AND SWORN to before me, this _____________________ at Tanauan City, Batangas, Philippines, affiants exhibiting to me their respective Community Tax Certs. Nos. _________ and __________ both issued at Talisay, Batangas on _____________, 2020.

Doc. No. _______;

Page No. _______;

Book No._______;

Series of 2020.

Note: All of information's like name, address and other sensitive information are not true and this is for example purposes only.