REPUBLIC OF THE PHILIPPINES)

QUEZON CITY
) S.S

JOINT AFFIDAVIT OF TWO DISINTERESTED

PERSONS
We, FLORENCIO LOREJAS DUMALAG, Filipino, of legal age,
married and a resident of No. 18-T Dumalay Street Brgy. Sta Monica,
Novaliches, Quezon City and ROBERTO TULIAO ROSARIO, Filipino, of
legal age, married and a resident of No. 12, Dona Rosario, Buenamar,
Novaliches, Quezon City, after having been duly sworn to in
accordance with law, hereby depose and state, that:
1. We personally know the deceased ERIBERTO UNDAY MAARAT,
a member of the Social Security System with SSS No. 032620236-2, who was born on March 16, 1949 in the City of
Baybay, Leyte. We personally know the late ERIBERTO UNDAY
MAARAT, because we have been friends and neighbors for a long
period of time.
2. In the Certificate of Live Birth and Certificate of Baptismal of the
late ERIBERTO UNDAY MAARAT, the names BALBINO
MAARAT and APOLONIA UNDAY are indicated as the names
of the father and the mother. However, since ERIBERTO UNDAY
MAARAT was a young child, he used to call his mother by the
nickname FLORA until he grew up.
The copies of the
mentioned Certificates are herein attached as ANNEX A and
ANNEX B, respectively.
3. Said ERIBERTO UNDAY MAARAT got married to GLORIA
ORAO-MAARAT on January 10, 1974 at Baybay, Leyte. In
accordance with the said marriage, a Marriage Contract was
issued by the Office of the Local Civil Registrar. However, in the
said Marriage Contract, the name ALBINO MAARAT was
indicated as the name of the father, and FLORA UNDAY as
name of the mother. The discrepancy in the name of the Father,
whose true and real name is BALBINO, was due to the clerical
error of the Office of the Local Civil Registrar of Baybay, Leyte. As
to the discrepancy in the name of the Mother, whose true and
real name is APOLONIA, the reason is that ERIBERTO UNDAY
MAARAT used to call his mother by the nickname FLORA. A

copy of the said Marriage Contract is herein attached as ANNEX

C.
4. When ERIBERTO UNDAY MAARAT filed his application with the
Social Security System, he indicated therein BALBINO
MAARAT as the name of the Father, and FLORA UNDAY as
the name of the Mother. His failure to indicate the true and
correct name of his mother was made in good faith and without
intent to provide false information, as he only thought that it was
not necessary anymore to declare his mothers real name, since
most people would only call his mother by the nickname
FLORA.
5. As their close friends and neighbors, we are competent to attest
to the fact that the names, ALBINO MAARAT (as per his
Marriage Contract), and BALBINO MAARAT (as per his
Certificate of Live Birth and Baptismal Certificate), refer to one
and the same person, the latter being his complete and real
name. We can further attest to the fact that the names FLORA
UNDAY (as per his SSS E-1 Form and Marriage Contract) and
APOLONIA UNDAY (as per his Certificate of Live Birth and
Baptismal Certificate), refer to one and the same person, the
latter being her complete and real name.
That we are executing the foregoing Joint Affidavit in order to
attest to the truth that the names, ALBINO MAARAT and
BALBINO MAARAT refer to one and the same person, the latter
being his true and correct name, and the names FLORA UNDAY
and APOLONIA UNDAY refer also to one and the same person, the
latter being her true and correct name per Certificate of Live Birth and
Baptismal Certificate, in support of application for Death Benefit Claims
with the SSS and for whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto affixed our signatures
this 10th day of July 2016 in Quezon City

FLORENCIO LOREJAS DUMALAG

TULIAO ROSARIO
Affiant

ROBERTO
Affiant

UMID No.: CRN-0111-0325915-5

SSS No.: 03-2705643-6

SUBSCRIBED AND SWORN TO before me this 10 th day of July 2016

in Quezon City, affiants having exhibited their respective identification
cards, the details of which are stated above.
Witness my hand and seal on the date and place written above.
Doc. No. 393
Page No. 80
Book No. XXVII
Series of 2016

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