Republic of the Philippines.…..

)
Province of Davao del Norte…) S.S.
City of Tagum ….……………..)

AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, DOLORES T. QUIROS, and ELIZABETH B. ANG, both of legal age, Filipino, married
and residents of Purok 3 Florida Kapalong, Davao Del Norte, after having been duly sworn to in
accordance with law, hereby depose and state:

That we personally know the person named MARIA NIEVES H. ARAT ;

That we know for a fact that MARIA NIEVES H. ARAT died last August 31, 2019 in
Kapalong, Davao del Norte;

That based on her Marriage Contract issued by the National Statistics Office currently
known as Philippine Statistics Authority, it recorded MARIA NIEVES as her First Name;

That in her Certificate of Death, her First Name was erroneously named as “NIEVES” but
in truth and in fact, her true and correct First Name is “MARIA NIEVES” which she has been using
since childhood as also reflected on her;

That “MARIA NIEVES H. ARAT”as appearing on the Marriage Contract and “NIEVES H.
ARAT” as found on the Certificate of Death hereto attached refers to one and the same person;

That we are not related to the said MARIA NIEVES H. ARAT by consanguinity or by
affinity, but we personally know all the aforestated facts because we are close friends and
neighbors for a long period of time;

That we execute this affidavit to attest to the truth of the foregoing facts and to inform the
proper authorities concerned regarding the matter.

IN WITNESS WHEREOF, we have set our hands this _____________________, in

Tagum City, Davao del Norte, Philippines.

DOLORES T. QUIROS ELIZABETH B. ANG

Affiant Affiant
UMID: CRN: 006-0028-78661 TIN: 729-099-290

SUBSCRIBED AND SWORN to before me this __________________ at Tagum City,

Davao del Norte, Philippines, affiants exhibited proofs of their identification written below their
names.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2019.