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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF TARLAC ) S.S.

JOINT AFFIDAVIT
OF TWO DISINTERESTED PERSONS
We, ROBERTO Q. SESUCA and DOMINGO C. GUMBA, 62
and 68 years old, Filipino citizens, and residents of Barangay
Sinulatan 1st, Camiling, Tarlac, Philippines, after having been duly
sworn to in accordance with law, do hereby depose and state THAT:

1. We both personally know MACARIO RETUYA GUTIERREZ


(Macario, for brevity), born on March 29, 1956 to Spouses
Angelino Gutierrez and Felicidad Retuya at Ataynan,
Bayambang, Pangasinan, Philippines;

2. Macario is a bonafide member of the Social Security System


(SSS);

3. Macario had been using MARIO as his First Name and MARCH
15, 1957 as his Date of Birth since he came to the age of
reason. As a result, all his transactions including in his SSS
records, pertinent documents except in his Certificate of Birth
bear such name and birthdate;

4. When Macario secured a copy of his Certificate of Birth from


the Office of the Local Civil Registrar of Bayambang,
Pangasinan, he discovered that his recorded first name and
date of birth appearing therein is MACARIO and MARCH 29,
1956;

5. While, in the SSS E-1 of Macario, the recorded name of his


father and his place of birth appearing therein is AQUILINO
GUTIERREZ and ALCALA, PANGASINAN, instead of his true and
correct name and place of birth ANGELINO GUTIERREZ and
BAYAMBANG, PANGASINAN as recorded in the above-said
Certificate of Birth, hence, the discrepancies;

6. We are not related to Macario by affinity or consanguinity,


except that of being his barangay mates;

7. We are executing this affidavit to attest to the fact that the


true and correct full name of Macarios father is ANGELINO
GUTIERREZ;

Doc. No. _____ Page No. _____ Book No. _____ Series of 2016.
8. We are executing this affidavit to attest to the fact that the
names MACARIO GUTIERREZ, who was born on March 29,
1956 at Ataynan, Bayambang, Pangasinan and whose fathers
name is Angelino Gutierrez appearing in the above-mentioned
Certificate of Birth, MARIO RETUYA GUTIERREZ, whose date of
birth appears as March 15, 1957 as recorded in all his
transactions, who was born in Alcala, Pangasinan and whose
fathers name is Aquilino Gutierrez appearing in his SSS E-1,
refer to one and the same person, and that is our barangay
mate, Macario Retuya Gutierrez;

9. Moreover, we are executing this affidavit to attest to the fact


that the name ANGELINO GUTIERREZ, as the father of Macario
Gutierrez appearing in the said Certificate of Birth, and
AQUILINO GUTIERREZ, as the father of Mario R. Gutierrez,
appearing in his SSS E-1 refer to one and the same person,
and that is the biological father of our barangay mate, Macario
Retuya Gutierrez;

10. Finally, we are executing this Affidavit to attest to the


truth of the foregoing statements and for all legal intents and
purposes it may serve.

IN WITNESS WHEREOF, we have hereunto affixed our


signatures this 21st day of January, 2016 at Camiling, Tarlac,
Philippines.

ROBERTO Q. SESUCA DOMINGO C. GUMBA


Affiant Affiant
SSS ID Card Unified Multi-Purpose ID Card
SSS No. 01-0166808-2 CRN-0111-2041821-2
Social Security System Government Service Insurance
System

SUBSCRIBED AND SWORN to before me on the date and


place indicated above. Affiants exhibited before me their respective
competent evidence of identity indicated below their names.

Doc. No. _____ Page No. _____ Book No. _____ Series of 2016.

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