REPUBLIC OF THE PHILIPPINES )

City of San Juan ) S.S.

AFFIDAVIT OF DELAYED REGISTRATION OF BIRTH
I, PENKY OMAS PABUNAN , of legal age, Single, Filipino and
residing at 97-I Yanga St., Maysilo, Malabon City, after having been
sworn to in accordance with law hereby depose and states that:
1. I am the daughter of Celestina Omas Pabunan and Cecilio Abaigan
Pabunan;
2. I was born on March 24, 1990 in Makati City;
3. Due to inadvertence of my parents, my birth was not reported and
registered with the Office of the Civil Registrar of Makati City
immediately thereafter; and
4. That I am executing this affidavit to attest to the truth of all the
foregoing facts, in connection with my application for the late
registration of my birth with the Office of the Civil Registrar of Makati
City and for whatever legal purpose this may serve.
FURTHER AFFIANT SAYETH NAUGHT.

PENKY OMAS PABUNAN

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 17th

day of
October 2014 in San Juan City, Philippines, affiant having exhibited to
me his/her __________________ No. _______________ issued in
_________________________ on ________ 20_________.

NOTARY PUBLIC

DOC NO. ______;

PAGE NO. _____;
BOOK NO. I;
SERIES OF 2014.