REPUBLIC OF THE PHILIPPINES)
: S.S
_____________________________)
JOINT AFFIDAVIT OF
TWO DISINTERESTED PARTIES
We, and
, Filipinos, of legal age , married respectively and with residence and postal address in
subscribing under oath hereby depose and say:
1. That we personally know resident of
. He/ She is not our relative
either by affinity or consanguinity;
2. That also personally know as a fact that the said was
born on in
of the spouses and
who were likewise bona fide residents of the same place;
3. That we are executing this affidavit in order to make it known that
_______________________ with date of birth ______________ and
_____________________ with date of birth ______________ in the insurance
application is one and the same person.
4. That we are executing this affidavit to attest to the truth of the foregoing facts and for
whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this ________ day of
___________________ 20____ at ____________________________.
(Affiant) (Affiant)
Res. Cert. No. Res. Cert. No.
Issued on Issued on
at at
SUBSCRIBED AND SWORN to before me this ________ day of __________________
20____, at _____________________.
NOTARY PUBLIC
Doc No: __________;
Page No: __________;
Book No: __________;
Series of __________.