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2. That we also know and we hereby declare that the said ________________________
is married to ______________ and died on ____________________;
3. That we know for a fact that said person by the name of ____________________ as
known by many, and ________________ as appearing in her authenticated death
certificate issued by the National Statistics Office, refer to one and the same
person;
4. That we are not related in any way, either by consanguinity or affinity, to the
said _________________;
5. As such, we execute this Affidavit to certify or attest to the truth of the foregoing
facts and for whatever legal purpose that this Affidavit may serve.
IN WITNESS WHEREOF, we have set our hands this 4th day of October, 2005 at
Santiago City, Philippines.
_____________________ _____________________
Affiant Affiant
SUBSCRIBED AND SWORN to before me, this 4th day of October, 2017 at
Santiago City, Philippines, by the Affiants with their competent evidence of identity,
both of whom are personally known to me.
Notary Public
Doc. No. 1;
Page No. 1;
Book No. I;
Series of 2005.