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Affidavit of Two Disinterested Persons (Late Registration) ELIGIA FERNANDEZ

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Republic of the Philippines)

Province of Pangasinan ) S.S.


Municipality of San Jacinto)
x----------------------------------------x

AFFIDAVIT OF TWO DISINTERESTED PERSONS


(Re: Late/Delayed Registration of Birth)

            We, NORMA D. MONTEMAYOR and CONCHITA B. TUCAY, both of


legal ages, Filipino citizens, and with the residence address at and Brgy. Capaoay, San
Jacinto, Pangasinan, after having been duly sworn and oath in accordance with law
hereby voluntarily depose and say:

1.  That we personally known ELIGIA REYES FERNANDEZ, daughter of


JUAN SR A. FERNANDEZ and ELIGIA R. REYES, who was born on 27th
day of April 1935 at San Jacinto, Pangasinan, Philippines;

2.  That due to the negligence and/or inadvertence on the part of his parents and
the prevailing conditions then, his birth was not registered;

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
in the province;

4. That we are not related to , ELIGIA REYES FERNANDEZ by


consanguinity or affinity;

5.  That we are executing this 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 ELIGIA REYES FERNANDEZ, and for whatever legal
purpose this may serve.

IN TRUTH WHEREOF, we have hereunto set our hands this 13th day of April
2023 at San Jacinto, Pangasinan, Philippines.

NORMA D. MONTEMAYOR CONCHITA B. TUCAY


Affiant Affiant
OSCA No.: 6171 OSCA No.: 6359

SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and


for San Jacinto, Pangasinan, 13th day of April 2023. Affiants personally came and
appeared to my office, personally known to me and to me known to be the same person
who personally signed the foregoing instrument before me and avowed under penalty of
law to the whole truth of the contents of said instrument.

ATTY. ANNA MARI E. ABARCAR


Doc No. 363; NOTARY PUBLIC
Page No. 74; Until December 31, 2023
Book No. XIV; Roll of Attorney’s No.68056
Series of 2023. PTR No. 9798269/ 03 Jan 23
IBP No. 261088/ 03 Jan 23
Capaoay, San Jacinto, Pangasinan

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