Affidavit-Child Was Not Born

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REPUBLIC OF THE PHILIPPINES)

CITY OF ORMOC ) S.S.

JOINT AFFIDAVIT

We, MARK D. RACHO and GEMMA U. RACHO both of legal age, Filipinos,
married to each other and both residents at Barangay Bantigue, Ormoc City, Leyte,
Philippines, after having been duly sworn to in accordance with law, do hereby
depose and say that:

1. We personally are the biological parents of a stillbirth of a baby girl


named ANGEL U. RACHO;

2. The said baby was buried at Public Cemetery located at Barangay Can-
adieng, Ormoc City, Leyte, Philippines sometime on March 18, 2005;

3. That we plan to transfer her burial in Ormoc City Memorial Garden,


located at Barangay Can-adieng, Ormoc City, Leyte;

4. That the said baby has no Certificate of Live Birth/Death Certificate as per
Local Civil Registrar of Ormoc City due to stillbirth;

5. We are executing this affidavit to attest the veracity of the foregoing facts
and for whatever other legal purpose this serves best.

Affiant further sayeth naught.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __ day


of ____________ at Ormoc City, Philippines.

MARK D. RACHO GEMMA U. RACHO


Affiant Affiant
Valid ID:_______________ Valid ID:______________

SUBSCRIBED AND SWORN TO before me this __ day of _________ at Ormoc


City, Philippines.

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