REPUBLIC OF THE PHILIPPINES)

CITY OF BACOLOD )
X---------------------------------------X

JOINT AFFIDAVIT

We ARLINE O. VILLALUZ, and ROGELIO B. FURING both of legal age, Filipino, and a
resident of Bacolod City, Negros Occidental, Philippines, after having been duly sworn in accordance
with the law, depose and say:

That we personally know that REBECCA ETANG SOBREMISANA had given birth to a child
on May 23, 2018 at the Adventist Medical Center-Bacolod, Bacolod City;

That the attendant to the delivery of the said child was EIREEN B. DE LEON, MD addressed at
Adventist Medical Center – Bacolod, Bacolod City, Negros Occidental, Philippines.

That the said child was baptized on August 27, 2018 and was given the name of SHANELLE
SOBREMISANA at Barangay Bunga, Salvador Benedicto, Negros Occidental, Philippines.;

That the father of the child is JERALD LOBATON REBATADO who is a resident of Manihan,
Barangay Bunga, Salvador Benedicto, Negros Occidental, Philippines.

That we know these facts in as much as we used to be neighbors and we were among the guest
who attended the baptismal party;

That we execute this affidavit to establish the facts about the birth of SHANELLE
SOBREMISANA, the illegitimate child of REBECCA ETANG SOBREMISANA, who was born on
May 23, 2018 but was not registered on time at the Office of the City of Civil Registrar of Bacolod City.

IN WITNESS WHEREOF, we set our hands on this affidavit this __________ day of _________
at the City of Bacolod, Philippines.

________________________ ________________________
ARLINE O. VILLALUZ ROGELIO B. FURING

SUBSCRIBED AND SWORN to before me this ______ day of _____________ 20_____

at _______________________________, Negros Occidental, affiant exhibiting to me his
__________________________ with number __________________ as valid proof of his identity.

NOTARY PUBLIC

Doc No. _______

Page No. _______
Book No. _______
Series of 20 _____