Sample Joint Affidavit of Two Disinterested Persons for Delayed Birth Registration

Republic of the Philippines )  __________…………  __________……………………….) …………….) SS. x----------------------------x

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS (FOR

DELAYED REGISTRATION OF BIRTH )

WE, ___________________ and ___________________, both of legal age, Filipinos and all residents of ________________________________, after haing been dul! s"orn to in accordance "ith la", do hereb! depose and state that# $. We %no" the facts facts and circu&stan circu&stances ces surroundin surrounding g the birth of the child na&ed _____________ _____________________ ____________ ____ "ho "ho "as "as born born on ____ ______ ____ ___ _ at  ______________  _____________________ _____________ ____________ ______ to his'her biological parents  ______________  ____________________ ______ and ________________________, both being our personal ac(uaintances'neighbors *. +he said child "as born outside of "edloc% If  If married, “The parents of  the said child were validly married on _______________ at   ______________  ____________________ __________ ____ solemnized by _______________ ______________________ _______ per  Certificate of Marriage No. _______________! . +he birth of the said child "as attended b! r. __________________, a dul! licensed ph!sician of the sa&e hospital  If traditional hilot, “The birth of  the said child child was attended attended by ______ _________ _______ ______, __, a Tradition Traditional al "ilot of   ______________  _____________________ ____________! _____! /. +he said child "as i&&uni0ed and but not !et) bapti0ed since one of the re(uire&ents for baptis& is the child1s birth certificate "hich is still being applied for dela!ed registration omit omit if already imm#nized and baptized  baptized ) ) 2. +he birth certificate of the said child "as not i&&ediatel! registered "ith the 3ffice of 4it! 4iil Registrar, _______________, pri&aril! because of the inadertence of the parents or failure of the persons) delegated to do so, hence, this 5oint 6ffidait 7. +he birth birth certifica certificate te of the said said child is not not registered registered "ith "ith an! 3ffice 3ffice of the 8ocal'9unicipal'4it! 4iil Registrar Registrar :. We We a are re exe execu cutin ting g this this 5oint 5oint 6ffid 6ffida ait it to to attes attestt to the truth truth of of the the foreg foregoin oing g facts of birth and to support the the application for dela!ed registration registration of of the sa&e "ith the 3ffice of the 4it! 4iil Registrar, ________________. IN WITNESS WHEREOF, "e hae hereunto set our hands this _____________ at _______________________.

_________________

_________________

Afant ID No. ___________  Valid until __________ 

Afant ID No. ___________  Valid until __________ 

SUBSCRIBED AND  ______________  _________________. ___.

Doc. №:________________; Page №:________________; Book №:________________; Series of 2!".

SWORN

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befo before re

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this this

____ ______ ____ ____ ____ ____ ___ _

at

 NOTARY  NOTARY PUBLIC WITNESS

Affiant DSWD 4P’s Beneficiary ID No. 1602020 Issued at Butuan City