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City of Zamboanga ..)S.S.
For Zamboanga del Sur)
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AFFIDAVIT OF ACKNOWLEDGMENT/ADMISSION
OF PATERNITY
I, SATURNINO V. COSEP, of legal age, married, Filipino and a resident of Solar,
Olutanga, Zamboanga del Sur, Philippines, after having been duly sworn to an oath in
accordance with law hereby depose and state:
1
RAYMUNDO COSEP,Jr.
Witness
SUBSCRIBED AND SWORN TO BEFORE ME, this 17th day of August, 2002 at
Zamboanga del Sur, Philippines.
AFFIDAVIT
I, GEMALYN P. COSEP, of legal age, married, Filipino, and a resident of Ipil,
Zamboanga Sibugay, Philippines, after having sworn in accordance with law, do hereby
depose and state:
1. That I am a member of Pantawid Pamilyang Pilipino Program at
Ipil, Zamboanga Sibugay;
2. That as a member thereof, I am required to correct my Birth
Certificate and Marriage Contract entries;
3. That some discrepancy of entries of the following documents
hereunder avers:
DOCUMENT
DISCREPANCY
TRUE/CORRECT
WITNESS
WHEREOF,
have
hereunto
affixed
my
signature
this
GEMALYN P. COSE
Affiant
SUBSCRIBED AND SWORN to before me this _____________________, at
Zamboanga City, for Zamboanga Sibugay, Philippines.
I, NOEL INTAC SALATAN, of legal age, married, Filipino, and a resident of Gov.
Ramos, Sta. Maria, Zamboanga City, Philippines, after having sworn in accordance
with law, do hereby depose and state:
6. That I am a bonafide member of Phil Health and registered under no.
14-000004895-6;
7. That one of my beneficiaries is my mother, AQUILINA INTAC SALATAN,
85 years of age, under my custodial care and presently confined at
Ciudad Medical, Zamboanga City due to various ailments;
8. That in her Phil Health Record, her Date of Birth is May 17, 1928 which
is her true and actual date of birth as appearing in her Birth
Ccertificate and other public documents. However, in her medical
records with Ciudad Medical, Zamboanga City, her Date of Birth is May
15, 1928;
9. That in the same Philhealth Record, her middle initial appears as I.
The same stands for the name INTAC;
10.That the Birth Certificate in her possession was damaged together
with her Marriage Contract, Senior Citizen I.D. and other documents
due to termite infestation in her room, hence, we decided to dispose
them;
11.That I am executing this affidavit of discrepancy and loss to attest to
the truth of the foregoing facts and to establish the damage and loss
of the above-stated documents.
IN
WITNESS
WHEREOF,
have
hereunto
affixed
my
signature
this