REPUBLIC OF THE PHILIPPINES)

CITY OF ___________________……………………) S.S

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, Leonisa Baron and Romea Pedro, both of legal age, Filipinos
and residents of (Address) after having been duly sworn to in accordance
with law, do hereby depose and say:
1. That we personally know Anna L. Torres who was born on
September 9, 1965 at XXXX;

2. That her true and correct full name is Anna L. Torres, as reflected
in her NSO Authenticated Certificate of Live Birth;

3. That however, her son- Romeo L. Torres mistakenly indicated or

spelled her name as Ana L. Torres as beneficiary in the former’s
SSS membership form;

4. That the error may have been caused by mere inadvertence of the
filling out of the SSS form of her son;

5. That the names Anna L. Torres in the NSO Birth Certificate and
Ana L. Torres as beneficiary in the SSS membership form of
Romeo L. Torres, REFERS TO ONE AND THE SAME
PERSON;

6. That we are not in any way related to the above mentioned person
nor do we have pecuniary interest in this matter whatsoever;

7. That we are executing this affidavit to attest the truth of the

foregoing facts and for whatever legal purpose it may serve.

AFFIANTS FURTHER SAYETH NOT.

IN WITNESS WHEREOF, we have hereunto set our hands this

___th day of March 2019 at _____________________.

LEONISA BARON ROMEA PEDRO

AFFIANT AFFIANT
Voter’s ID Senior Citizen’s ID
with no. 0000
BEFORE ME, appear the persons of:

LEONISA BARON ROMEA PEDRO

presenting the above JOINT AFFIDAVIT OF TWO (2) DISINTERESTED

PERSONS, who are personally known to me or identified by me through
competent evidence of identity as defined by the Notarial Rules as the
persons who sign the document and in my presence taken an oath or
affirmation before me as to such document.

SUBSCRIBED AND SWORN to before me this ___ day of March

2019 at _____________________, Philippines, affiants having exhibited to
me their Competent Evidence of Identity bearing their pictures and
signatures.

_________________________
Notary Public

DOC. NO. ____;

PAGE NO. ____;
BOOK NO. ____;
SERIES OF 2019.