REPUBLIC OF THE PHILIPPINES)

CITY CEBU ) S.S.

AFFIDAVIT OF TWO DISINTERESTED PERSONS

(FOR DELAYED REGISTRATION OF BIRTH)

WE, IMELDA N. MALINGIN and ANABEL ANDALES, both of legal age,

Filipinos and all residents of Barangay Subabasbas, Lapu-lapu City, Cebu, after
having been duly sworn and oath in accordance with law hereby voluntarily depose
and say:

1. We know the facts and circumstances surrounding the birth of the child named
Lendsay Jean R. Jurado who was born on January 30, 2015 at Barangay Subasbas,
Lapu-lapu City to his/her biological parents Melvin Flores Jurado and Letecia
Rebutazo, both being our personal acquaintances/neighbors;

2. That the said child was born outside of wedlock;

3. That the birth of the said child occurred was attended by Helen Corvo, a registered
midwife;

4. That the said child was immunized but not yet baptized since one of the requirements
for baptism is the child’s birth certificate which is still being applied for delayed
registration;

5. That the birth certificate of the said child was not immediately registered in the Office
of the City Civil Registrar, primarily because of the inadvertence of the parents or
failure of the persons delegated to do so, hence, this Joint Affidavit;

6. The birth certificate of the said child is not registered with any Office of the Local
Civil Registrar;

7. We are executing this Joint Affidavit to attest the truth of the foregoing facts of birth
and to support the application for delayed registration of the same with the office of
the Local Civil Registrar, Lapu-lapu City.
IN WITNESS WHEREOF, WE have hereunto set our hands this 8th day
of December 2018 in Cebu City, Philippines.

ANABEL ANDALES IMELDA N. MALINGIN

AFFIANT AFFIANT
Unified Multi-purpose ID CRN- DOH ID RO7-207-2018-03-000266
0111-6404720-9

SUBCRIBED AND SWORN TO before me this 8th day of December 2018 in

Lapu-lapu City, Philippines, affiants exhibiting to me their competent proof of
identity, stated above, below their names and signatures.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2018.