Suico JOINT

Republic of the Philippines )
Butuan City…………………) SS.

x------------------------------------x
JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS
We, CAROLINE BEJARANG SIMAN and WILLIAM PAUL GALEMBA JAMERO

both of legal age, Filipinos, and are residents of P-6 Baan KM 3, Butuan City and P-2
Taod-oy Magallanes, Agusan del Norte, Philippines, do hereby depose and state that:
1. We personally know the child named RONJIE SUICO who was born on 16
February 2008 at P-6 Baan KM 3, Butuan City, to her parents ROMEL
JAMITO CUSIT and MARGIE CAMILLO SUICO;
2. We know that the child was born out of wedlock;
3. We know that the child’s birth was assisted/attended by Florencia Caberte,

Hilot of P-6 Baan KM 3, Butuan City;
4. We know that the child was already immunized but not yet baptized;
5. We know that that the child was not immediately registered with the Office
of City Civil Registrar, Butuan City, due to financial constraints;
6. The child’s Birth Certificate is not registered with any Office of the
Local/Municipal/City Civil Registrar; And,
7. We are executing this Joint Affidavit to attest to the truth of the foregoing facts
of the birth of RONJIE SUICO and to support the application for delayed
registration of the same with the Office of the City Civil Registrar, Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 06th day of
August 2018 at Butuan City, Philippines.
CAROLINE BEJARANG SIMAN WILLIAM PAUL GALEMBA JAMERO

Affiant Affiant
PhilHealth Identification Card No. UMID
18-025238964-2 CRN-0111-5939004-2
Issued in Butuan City Issued by SSS in Butuan City
SUBSCRIBED AND SWORN to before me this 06th August 2018 at Butuan City,
Philippines. Affiants exhibited their identification cards as stated below their respective
names.
ATTY. GLAIZA MAE L. LAGUNDE

NOTARY PUBLIC
Doc. №:________________;
Page №:________________;
UNTIL DECEMBER 31, 2018
Book №:________________; ROLL NO. 67582 05-25-2017
Series of 2018. IBP NO. 1061837 01-03-2018 B.C
PTR NO. 1453427 01-03-2018 B.C
TIN: 325-797-107
x------------------------------------x
WE,ANGELA MAE ESPINA ARRIOLA and KATRINA FAJARDO

BUDLONGboth of legal age, Filipinos, and areresidents ofPurok 3, Brgy.Obrero and
Brgy. Luz Village, all of Butuan City, Agusan del Norte,Philippines, do hereby depose
and state that:
1. We personally knowthe child named AARON JAMES SERATE

OLVIDOwho was born on 30 April 2010 at Purok 3, Brgy. Bonbon, Butuan
City to herparents GRASELLE AZURA SERATE and DELSON
HORCERADA OLVIDO, JR.;
3. We know that the child’s birth was attended/ assisted by Candida Peral,
hilot of Purok 5, Brgy. Bonbon;
4. We know that the child was already immunized andbaptized;
5. We know that that the childwas not immediately registered with the Office
of City Civil Registrar, Butuan City, due to financial constraints;
6. The child’s Birth Certificate is not registered with any Office of the
7. We are executing this Joint Affidavit to attest to the truth of the foregoingfacts
of the birth ofAARON JAMES SERATE OLVIDOand to support the application
for delayed registration of the same with the Office of the City Civil Registrar,
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 07 June2018 at

Butuan City, Philippines.
ANGELA MAE ESPINA ARRIOLA KATRINA FAJARDO BUDLONG

Affiant Affiant
The Fraternal Order of Eagles, Phil. Eagles Driver’s License Card
Identification Card No. No. K01-13-001345
2018-03-81-L-4098 Issued inButuan City
Issued in Butuan City
SUBSCRIBED AND SWORN to before me this 07 June 2018at Butuan City,

Philippines.Affiants exhibited their identification cards as stated below their respective
names.

NOTARY PUBLIC
Republic
Doc. of the Philippines )
№:________________; UNTIL DECEMBER 31, 2018
Page №:________________;
Butuan City…………………) SS. ROLL NO. 67582 05-25-2017
Book №:________________;
x------------------------------------x
Series of 2018 IBP NO. 1061837 01-03-2018 B.C
PTR NO. 1453427 01-03-2018 B.C
TIN: 325-797-107
WE, GIENEN JOY E. ESPELITAandMAY SHAYNE R. DOLERAboth of legal

age, Filipinos, and are residents ofPurok 1, Upper Doonganand Santan Street Saint
Joseph, respectively, all of Butuan City, Agusan del Norte, Philippines, do hereby
depose and state that:
1. We personally know the child named AKIHIRO EIJI CABILAN

WAKITAwho was born on 03 February 2018 at Butuan Doctor’s Hospital,Butuan
City to her parentsLOVELY ANGEL DALAGAN CABILAN and PEDRO
KENJI LURA WAKITA;
3. We know that the child’s birth was assisted/ attended by Dr. Maria Chita
S. Itao, attending physician of the said hospital;
4. We know that the child wasalready immunized but not yetbaptized;
5. We know that the child’s birth was not immediately registered with the
Office of City Civil Registrar, Butuan City, due to time and financial
constraints;
6. The birth certificate of the said child is not registered with any Office of
the Local/Municipal/City Civil Registrar; And,
of the birth of AKIHIRO EIJI CABILAN WAKITA and to support the
application for delayed registration of the same with the Office of the City Civil
Registrar, Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 20th day of June
2018 at Butuan City, Philippines.
GIENEN JOY E. ESPELITA MAY SHAYNE R. DOLERA

Affiant Affiant
Driver’s License Card No. PhilHealth Identification Card No.
K0114001191 18-025155072-5
Issued in Butuan City Issued in Butuan City
SUBSCRIBED AND SWORN to before me 20th day of June 2018 at Butuan City,
names.

Doc. №:________________; NOTARY PUBLIC
Page №:________________; UNTIL DECEMBER 31, 2018
Book №:________________; ROLL NO. 67582 05-25-2017
Series of 2018.
Republic of the Philippines ) IBP NO. 1061837 01-03-2018 B.C
Butuan City…………………) SS. PTR NO. 1453427 01-03-2018 B.C
x------------------------------------x TIN: 325-797-107
WE, RODOLFO BARRIENTOS SUMANDURANandVICKY PANDITA

BERUAN both of legal age, Filipinos, and are residents of Brgy. 12,
TndangSora,Villanueva Ext., Butuan City, and Purok-5, Ube, Maon, Butuan City,
respectively, all of Agusan del Norte, Philippines, do hereby depose and state that:
1. We personally know the child namedMARY ROSE MOSO TALIBONGwho

was born on 26 Dec. 2005 atP-8, Dumalagan, Butuan City, to
herparentsROSALINDA COCO MOSO and RODOLFO CABABAT
TALIBONG;
3. We know thather birth was assisted/ attended by Juanita Matilos, Hilotof

P-8, Dumalagan, Butuan City;
4. We know that the she wasalready immunized and baptized;
5. We know that her birth was not immediately registered with the Office of
City Civil Registrar, Butuan City, due to timeconstraints;
of birth ofMARY ROSE MOSO TALIBONG and to support the application or
delayed registration of the same with the Office of the City Civil Registrar,
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 2ndday of July
RODOLFO BARRIENTOS VICKY PANDITA BERUAN

SUMANDURAN Affiant
Affiant Voter’s ID No.
PAGIBIG ID 0202-0006B-C1287VP20000
No. 1211-8431-8677 Issued by COMELEC, Butuan City
Issued in Butuan City
SUBSCRIBED AND SWORN to before me this 2nd day of July 2018at Butuan
City, Philippines.Affiants exhibited their identification cards as stated below their
respective names.
ATTY. MICHELLE M. EVANGELIO

Doc. №:________________; NOTARY PUBLIC
Page №:________________;
UNTIL DECEMBER 31, 2018
Book №:________________;
Series of 2018. ROLL NO. 67176 (5-24-2017)
IBP NO. 1061836 (1-3-18) B.C
PTR NO. 1454141 (1-4-18) B.C
TIN: 000-319-198-979
x------------------------------------x
WE, LEONIDA LAYON CASTAÑARESandADRIAN LAYONCASTAÑARES

both of legal age, Filipinos, and are residents of both Purok 5, Brgy. TandangSora,
Butuan City, Philippines, do hereby depose and state that:
1. We personally know the child namedJIAN DAVE BONGAY GONZALES

who was born on 03 April 2011 at Purok 6A, 9th Street, Guingona, JP. Rizal,
Butuan City to his parents DIONESIA TAROY BONGAY and ALAN
FAJARDO GONZALES;
2. We know that the child’s parents validly married on 28 September 2018 at

InahansaKanunay ng Panabang Chapel, 9th Street Guingona Subdivision, Butuan
City solemnized by Rev. Fr. Charles G. Patricio, Msc, Priest of the said Church;
3. We know that the child’s birth was assisted/ attended by Veronica Ochea,
Attending Hilot of Purok 6A, BrgyJ.P.Rizal, Butuan City;
4. We know that the child was immunized and baptized;
Office of City Civil Registrar, Butuan City, due to timeconstraints;
7. We are executing this Joint Affidavit to attest to the truth of the foregoing
facts of birth ofJIAN DAVE BONGAY GONZALES and to support the
application or delayed registration of the same with the Office of the City Civil
IN WITNESS WHEREOF, we have hereunto set our hands this 07 February 2018
at Butuan City, Philippines.
LEONIDA LAYON CASTAÑARES ADRIAN LAYON CASTAÑARES
Affiant Affiant
Voter’s Identification Card Taxpayer’s Identification Card
No. 0202-0046A-I2566LLC20000 No. 445-850-291-000
Issued by COMELEC, Butuan City Issued by BIR, Butuan City
SUBSCRIBED AND SWORN to before me 07 February 2018 at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018
x------------------------------------x
WE, ABEGAIL TIOAQUEN MATURANandJENNIFER AVENIDO

SILVOSAboth of legal age, Filipinos, and are residents of both Brgy. Ambago and Brgy.
Mahogany all of Butuan City, Philippines, do hereby depose and state that:
1. We personally know the child namedZEPHIA TRIXIA CYCILLE ATAZAN

TANwho was born on 02 May 2018 at Manuel J. Santos Hospital, Butuan City to
her parentsMATRIX TRACY LEONARDO ATAZAN andJOSEPH KENRICH
LOUIE GARME TAN;
2. We know that the child’s parents were validly married on 23 January 2016 per
Certificate of Marriage bearing registry no.2016-110;
3. We know that the child’s birth was assisted/ attended by Dr. Virginia M.
Flores, attending Physician of the said Hospital;
facts of birth ofZEPHIA TRIXIA CYCILLE ATAZAN TANand to support the
IN WITNESS WHEREOF, we have hereunto set our hands this 01 June 2018 at
ABEGAIL TIOAQUEN MATURAN JENNIFER AVENIDO SILVOSA
Affiant Affiant
Taxpayer’s Identification Card Voter’s Identification Card
No. 710-833-479-000 No. 0202-0113A-1877JAS2000
Issued by BIR, Butuan City Issued by COMELEC, Butuan City
SUBSCRIBED AND SWORN to before me 01 June 2018 at Butuan City,

names.

Doc. №:________________;
NOTARY PUBLIC
Page №:________________;
Book №:________________; UNTIL DECEMBER 31, 2018
Series of 2018 ROLL NO. 67176 (5-24-2017)
IBP NO. 1061836 (1-3-18) B.C
PTR NO. 1454141 (1-4-18) B.C
TIN: 000-319-198-979
x------------------------------------x
WE, DONATO S. LAMBONAOandPERFECTO O. MOCAboth of legal age,

Filipinos, and are residents of both Purok 3, Brgy. Port Poyohon, all of Butuan City,
Philippines, do hereby depose and state that:
1. We personally know the child namedALBERT ESARSA PAG-ONG who was

born on 25 May 1971 at East Mindanao, R. Calo Street, Butuan City to his
parents ARSENIA TOYOGON ESARSA and EPIFANIO MONTECALVO
PAG-ONG;
2. We know that his parents validly married on 22 April 2002 at San Vicente
Ferrer Chapel, Port Poyohon, Butuan City, solemnized by Rev. Fr. Gabriel B.
Avelino, Parish Priest of the said Church;
3. We know that hisbirth was assisted/ attended by Dr. TeresitaBusico,

attending physician of the said Hospital;
4. We know that he was baptized;
facts of birth ofALBERT ESARSA PAG-ONG and to support the application
or delayed registration of the same with the Office of the City Civil Registrar,
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 09 August 2017
DONATO S. LAMBONAO PERFECTO O. MOCA
Affiant Affiant
Senior Citizen Identification Card SSS Identification Card
No. 24464 No. 108-0440598-2
Issued by OSCA Butuan City Issued by SSS, Butuan City
SUBSCRIBED AND SWORN to before me 09 August 2017 at Butuan City,
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017
x------------------------------------x
WE, JENNIFER A. SILVOSAandWELMA MOLDE ENTONGboth of legal age,

Filipinos, and are residents of both Purok 5A and Purok 6A, Brgy. Silad Mahogany,
Butuan City, Agusandel Norte, Philippines, do hereby depose and state that:
1. We personally know the child PRINCES APPLE JOY SAJOR GORDO who
was born on June 26, 2010 at Purok 3AMahogany Butuan City to her parents
MARICEL DABLO SAJOR and SERGIO GULAY GORDO;
2. We know that the child’swas born out of wedlock;
3. We know that his birth was assisted/ attended by Lourdes B. Mao,

Attending Hilot of Purok 5B, Brgy. Baan Riveside, Butuan City;
constraints;
facts of birth ofPRINCES APPLE JOY SAJOR GORDO and to support the
JENNIFER A. SILVOSA WELMA MOLDE ENTONG
Affiant Affiant
Employee’s Identification Card PhilHealth Identification Card
No. 02-211 No. 18-200705248-1
Issued by the City Government of Butuan Issued by SSS, Butuan City
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE, ROSEJANE ATEGA ARRIOLA andJHEAN CENIZA FLOREZboth of legal

age, Filipinos, and are residents of both PUROK 5 AMBAGO, Butuan City, Agusan del
Norte, Philippines, do hereby depose and state that:
1. We personally know the child SHELIT RECAÑA whowas born on 11

November 2013 at Butuan City to her parentSHERYLL FLORES RECAÑA;
2. We know that the child’s was born out of wedlock;
3. We know that his birth was assisted/ attended by DOCTOR MAURINE C.

TAN;
constraints;
facts of birth ofSHELIT RECAÑAand to support the application or
Butuan City.
ROSEJANE ATEGA ARRIOLA JHEAN CENIZA FLOREZ
Affiant Affiant
SSS Identification Card BIR Identification Card
No. 08-1078663-7 No. 700-282-548-000
Issued by the SSS,Butuan City Issued by BIR, Butuan City
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE, ELIZABETH F. MALBAS and FREDDIE M. SULLANO both of legal age,

Filipinos, and a resident of Purok 3, Brgy. Amparo and Purok 6A, Brgy. Mahogany,
respectively all of Butuan City, after having been duly sworn to in accordance with law
do hereby depose and state that:
1. We personally know child named CALLEB JOHN POTESTAS APARTE who

was born on 09 May 2017 at Mothers Health First Birthing Home, Butuan City
to his parents EVELYN SUROY-SUROY POTESTAS and OLIVER BURIAS
APARTE
2. We knowthat the said child ‘s parents was validly married on 24 May 1998 at
Christ the King Church at Tungao, Butuan City solemnized by Rev. Fr. Avelino
N. Balatucan of the said Church;
4. We know that the child’s birth was assisted/ attended by Dr. Geraldine
Malbas, attending physician of the said Clinic;
5. We know that the said child was already immunized but not yet baptized;
Office of City Civil Registrar, Butuan City, due to time constrainst;
facts of birth of CALLEB JOHN POTESTAS APARTE and to support the
IN WITNESS WHEREOF, we have hereunto set our hands this 29 June 2017 at
ELIZABETH F. MALBAS FREDDIE M. SULLANO

Affiant Affiant
E,ployee’s Identification Card Employee’s Identification Card
No. 02-019-1 No. 127
Issued by the City Government Issued by by the City Government of
of Butuan Butuan
SUBSCRIBED AND SWORN to before me this 29 June 2017 at Butuan City,
na
Doc. №:________________;
x------------------------------------x
Page №:________________;
Book №:________________;
Series of 2017.
WE, CYNTHIA MAESTRADO CULLANTES and NIDA V. FERNANDEZ,

both of legal age, Filipinos, and are residents of both Brgy. Doonganand Village II ,Brgy.
Libertad, all of Butuan City, Philippines, do hereby depose and state that:
1. We personally know CAPISTRANO FURIA CUBILLAS JR. who was born on

27 September 1948 at Baan, Butuan City, to his parents CAPISTRANO MONTE
AGODO CUBILLAS SR. and NATIVIDAD ATO FURIA;
2. We know thathis parents are married but he doesn’t know when and where it
was because they’re already dead;
3. We know that he is already old and cannot remember the one who
attended/assisted his birth and because his parents are already dead;
4. We know that he was immunized and baptized;
5. We know that he was not immediately registered with the Office of City
Civil Registrar, Butuan City, due to financial constraints;
6. His Birth Certificate is not registered with any Office of the

of the birth ofCAPISTRANO FURIA CUBILLAS JR.and to support the
IN WITNESS WHEREOF, we have hereunto set our hands this 6thof July 2017
CYNTHIA MAESTRADO CULLANTES NIDA V. FERNANDEZ

Affiant Affiant
UMID Identification Card Employee’s Identification Card
No. CRN-006-0175-6416-6 No. 1032-10
Issued by SSS, Butuan City Issued by the City Government of Butuan
SUBSCRIBED AND SWORN to before me this 06th July 2017 at Butuan City,
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
x------------------------------------x
WE, ZENAIDA H. RAMOS andLEA PITOGO QUIBANboth of legal age,

Filipinos, and are residents of both Purok 2, Brgy. Upper Doongan and Purok 10, Brgy.
San Mateo,Butuan City, Philippines, do hereby depose and state that:
1. We personally know the child name DIOSDADO III LAHIMAO

SOBREMONTE who was born on 17 June 2013 at Purok 27, Brgy. Tungao,
Butuan City, Agusan del Norte to his parents ROMALYN JASPE LAHINAO
and DIOSDADO HIMO SOBREMONTE JR.;
2. We know that the child’s parents validly married on 20 August 2007 at San
Roque Catholic Chapel, Kauswagan, San Mateo, Butuan City, solemnized by
Rev. Fr. AlmadoEcarma, Roman Catholic Priest;
3. We know that the child’s birth was assisted/ attended by Melinda L.

Lahinao, Hilot of Brgy. Tungao, Butuan City;
4. We know that the child was already immunized and but not yet baptized;
constraints;
facts of birth of DIOSDADO III LAHIMAO SOBREMONTE and to support
the application or delayed registration of the same with the Office of the City
Civil Registrar, Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 25 July 2017 at
ZENAIDA H. RAMOS LEA PITOGO QUIBAN
Affiant Affiant
Senior Citizen Identification Card Taxpayer’s Identification Card
No. 25779 No. 470-223-068-000
Issued by OSCA,Butuan City Issued by BIR, Butuan City
SUBSCRIBED AND SWORN to before me 25 July 2017 at Butuan City,
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017
x------------------------------------x
WE, MARIAM B. HASSAN andZORAYDA AMER LAGUINDAB both of legal

age, Filipinos, and are residents of both Purok 7, Brgy. Bading, all of Butuan City,
1. We personally know the child named ASNAR QUISTADIO PANDIIN who

was born on 14 August 2010 at Purok 7, Brgy. Bading, Butuan City to his
parents EBRAHIM MENDEZ PANDIIN and JOAN PEREZ QUISTADIO;
3. We know that the child’s birth was assisted/ attended by SerafiaOptana,

Hilot of Purok 2 Camote, Brgy. Maon, Butuan City;
facts of birth ofASNAR QUISTADIO PANDIIN and to support the
MARIAM B. HASSAN ZORAYDA AMER LAGUINDAB
Affiant Affiant
4P’s Identification Card Voter’s Identification Card
No. 160202014-0121-00019 No. 0202-0117A-L0283ZAL20000
Issued by DSWD, Butuan City Issued by COMELEC, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x

1. We personally know the child named JOHAIRA QUISTADIO PANDIIN

who was born on 23 November 2007 at Purok 7, Brgy. Bading, Butuan City to his

facts of birth ofJOHAIRA QUISTADIO PANDIIN and to support the
Affiant Affiant
No. 160202014-0121-00019 No. 0202-0117A-L0283ZAL20000
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x

1. We personally know the child named ALI QUISTADIO PANDIIN who was
born on 23 November 2007 at Purok 7, Brgy. Bading, Butuan City to his

facts of birth ofALI QUISTADIO PANDIIN and to support the application
Butuan City.
Affiant Affiant
No. 160202014-0121-00019 No. 0202-0117A-L0283ZAL20000
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE, DONATO S. LAMBONAO andPERFECTO O. MOCA both of legal age,

Filipinos, and are residents of both Purok 3, Brgy. Port Poyohon, all of Butuan City,
1. We personally know the child named ALBERT ESARSA PAG-ONG who was
born on 25 May 1971 at East Mindanao, R. Calo Street, Butuan City to his
parents ARSENIA TOYOGON ESARSA and EPIFANIO MONTECALVO
PAG-ONG;
2. We know that his parents validly married on 22 April 2002 at San Vicente
Ferrer Chapel, Port Poyohon, Butuan City, solemnized by Rev. Fr. Gabriel B.
Avelino, Parish Priest of the said Church;
3. We know that his birth was assisted/ attended by Dr. TeresitaBusico,

attending physician of the said Hospital;
4. We know that he was baptized;
facts of birth ofALBERT ESARSA PAG-ONG and to support the application
Butuan City.
DONATO S. LAMBONAO PERFECTO O. MOCA
Affiant Affiant
Senior Citizen Identification Card SSS Identification Card
No. 24464 No. 108-0440598-2
Issued by OSCA Butuan City Issued by SSS, Butuan City
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017
x------------------------------------x
WE, JENNIFER A. SILVOSA andWELMA MOLDE ENTONGboth of legal age,

Filipinos, and are residents of both Purok 5A and Purok 6A, Brgy. Silad Mahogany,
Butuan City, Agusan del Norte, Philippines, do hereby depose and state that:
1. We personally know the child PRINCES APPLE JOY SAJOR GORDO who
was born on June 26, 2010 at Purok 3A Mahogany Butuan City to her parents
MARICEL DABLO SAJOR and SERGIO GULAY GORDO;
2. We know that the child’s was born out of wedlock;
3. We know that his birth was assisted/ attended by Dra. Natividad

Nazareno, Butuan City;
4. We know that the child was not immunized but already baptized;
Office of City Civil Registrar, Butuan City, due to financial constraints;
facts of birth of ROWENA DESPI VILLARINand to support the application
Butuan City.
EXALTACION B. CREDO TERESITA B. DELA TORRE
Affiant Affiant
Senior Citizen Identification Card Senior Citizen Identification Card
No. 15288 No. 2873
Issued by the OSCA, Butuan Issued by OSCA, Butuan City
SUBSCRIBED AND SWORN to before me 8 Septembert 2017 at Butuan City,
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE, ODILIO L. SITOYandLIGAYA B. SAVELLION both of legal age, Filipinos,

and are residents of Blk.-10 Lot-6 Emenville,Butuan Cityand Banza,Butuan City, do
hereby depose and state that:
1. We personally know the child namedCARLOS EMMANUEL PEREZ

RAMOSwho was born on 14 February 2017 at ButuanDoctors Hospital,Butuan
City to his parentsMARY JANE ROSELLO PEREZ and NESTOR JR.
CORBITA RAMOS;
2. We know that the child is born out of wedlock;
3. We know that his birth was assisted/ attended byDra. January M. Jayoma
attending physician of Butuan Doctors Hospital;
Office of City Civil Registrar, Butuan City, due to absence of the father;
facts of birth ofCARLOS EMMANUEL PEREZ RAMOSand to support the
IN WITNESS WHEREOF, we have hereunto set our hands this 07 September

ODILIO L. SITOY LIGAYA B. SAVELLION
Affiant Affiant
Employee’s Identification Card Employee’s Identification Card
No. 095-27 No. 4411-37
Issued by the City Government of Butuan Issued by the City Government of Butuan
City City
SUBSCRIBED AND SWORN to before me 07 September 2017 at Butuan City,
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE, ALBERTO VALDEZ CALOOYandFRANCISCA T. ACAMPADOboth of

legal age, Filipinos, and are both residents of Purok 8A, Barangay Ambago, Butuan
City,Agusan del Norte, Philippines, do hereby depose and state that:
1. We personally know AIDA J. CAÑETE who was born on 29 November 1952

at Cabcabon, Butuan City Agusan del Norte, to his parents FLORA CULINA
NOVO and EMELIO SAQUIREL JAOJAO;
2. We know that his parents validly married on 12 January 1976 at Dao,

Camahayan, Butuan City, solemnized by MSGR. Delfin M. Callao, Bishop of
Cabadbaran, Agusan del Norte;
3. We know that his birth was assisted/ attended by Elizabeth H. Atanog,

Attending Hilot of Purok 5, Brgy. Salvacion, Butuan City;
4. We know that the he was not immunized but alreadybaptized;
5. We know that the his birth was not immediately registered with the
facts of birth ofAIDA J. CAÑETE and to support the application or
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this3 November 2017
ALBERTO VALDEZ CALOOY FRANCISCA T. ACAMPADO Affiant
Affiant Taxpayer’s Identification Card
Driver’s License Identification Card No. 438-285-383-000
No.K01-04-000932 Issued by BIR, Butuan City
Issued by LTO, Butuan City
Valid until 2018-11-16
x------------------------------------xp
WE, ROXAN DUMAS GUMANIDand FLORDELIS G. ACASboth of legal age,

Filipinos, and are residents of Purok 5, Brgy. Bayanihan, Butuan City, do hereby depose
and state that:
1. We personally know the child namedKEANA LYZZA BAJAO who was born
on 07 May 2007 at Butuan City Provincial Hospital, Butuan City to her mother
ANIELA BIANCA BEATO BAJAO;
3. We know that his birth was assisted/ attended by Dr. Angel Antoinette L.
Devocion, Attending Physician of the said Hospital;
Office of City Civil Registrar, Butuan City, due to time constrainst;
facts of birth ofKEANA LYZZA BAJAO and to support the application or
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 02 October2017

ROXAN DUMAS GUMANID FLORDELIS G. ACAS
Affiant Affiant
PhilHealth Identification Card Employee’s Identification Card
No.18-025245957-8 No. 0058
Issued by PhilHealth, Butuan City Issued by City Health Office, Obrero,
Butuan City
SUBSCRIBED AND SWORN to before me 02 October 2017 at Butuan City,
names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------xp
WE, MARK KENNETH V. FIELandODILIO L. SITOY both of legal age,

Filipinos, and are both residents of Block 10, Lot 6 Ira Housing, Baan Km. 3, and 660
Brgy. Burgos, Butuan CityAgusan del Norte, Philippines, do hereby depose and state
that:
1. We personally know child named HUDAIFA CABUGATAN

MANGINSARAT who was born on 12 June 2017 at Mommy Grace Birthing
Clinic, Purok 3, Brgy. Ambago, Butuan City to her parents JUHAIMAH
CAGATAN CABUGATAN and EMRAN GOMEZ MANGINSARAT;
3. We know that his birth was assisted/ attended byKristina Marie C.

Mendoza, Registered Midwife and Registered Nurse of the said Clinic;
4. We know that the child was immunizedandbaptized;
Office of City Civil Registrar, Butuan City, due to time constraints;
facts of birth ofHUDAIFA CABUGATAN MANGINSARAT and to
support the application or delayed registration of the same with the Office of
the City Civil Registrar, Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this06 October2017 at

MARK KENNETH V. FIEL ODILIO L. SITOY
Affiant Affiant
Employee’s Identification Card Employee’s Identification Card
No. 11239 No. 095-27
Issued by the City Government of Butuan Issued by the City Government of Butuan

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE, MARY ANN ABRIOL ARQUISOLAandJULITO LABADORboth of legal

age, Filipinos, and are both residents of Purok1,Brgy. Jaguimitan,NasipitAgusan del
Norte, all of the Philippines, do hereby depose and state that:
1. We personally know child namedJAYVE CENIZA FULGENCIOwho was

born on 02November 2016 at Tungao, Butuan City to his parents MANILYN
CENIZA FULGENCIO and JUNE PANAGUITON FULGENCIO;
2. We know that the child’s parents is validly married on 14 February 2013 at

Guingona Park, Butuan City, solemnized by Former City Mayor of Butuan Hon.
Ferdinand M. Amante, JR.M.D;
3. We know that the childwas assisted/ attended by Deborah Mae E. Lopena,

Attending Midwife of Tungao,Birthing Clinic;
4. We know that the child was immunized and not yet baptized;
Office of City Civil Registrar, Butuan City, due to Time and Financial
constraints;
facts of birth ofJAYVE CENIZA FULGENCIOand to support the application
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this23 October 2017
MARY ANN ABRIOL ARQUISOLA JULITO LABADOR

Affiant Affiant
Voter’s Identification Card SSS’s Identification Card
No. 0209-0034C-E1881MAA20000 No. 33-6880176-0
Issued by COMELEC, Butuan City Issued by SSS, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 201
x------------------------------------x
WE,LHAZYL JEAN FRANCISCO EGUNA andJULIET MAKILING

MATURAN both of legal age, Filipinos, and are both residents of Purok 2, Brgy.
Dumalagan,Butuan City, all of the Philippines, do hereby depose and state that:
1. We personally know child namedRHIAN JAY BAÑES TAGUDwho was

born on 08April 2014 at R and J Maternity Clinic, Butuan City, ButuanCity to his
parents JERRY MAE BAÑES and RODRIGO TAGUD JR.;
3. We know that the child was assisted/ attended by Josephine L. Gallardo,

Attending Midwife of R and J Maternity Clinic,Butuan City;
constraints;
facts of birth ofRHIAN JAY BAÑES TAGUD and to support the application
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 23 October 2017
LHAZYL JEAN FRANCISCO EGUNA JULIET MAKILING MATURAN
Affiant Affiant
Philhealth’s Identification Card Philhealth’s Identification Card
No. 18-2500055739-8 No. 18-025188484-4
Issued by PHILHEALTH, Butuan City Issued by PHILHEALTH, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE,GINALYN CHUA MICAYABASandMELANIE MONTILLANO

APASboth of legal age, Filipinos, and are both residents of Blk.20 Lot 17 Ideal
Homes,Brgy. Libertad and Purok1,Brgy. Pianing,Butuan City, all of the Philippines, do
1. We personally know child namedETHAN LEO BAKISKISAN ARUELO

who was born on 02 September 2017 at BMC Hospital,Butuan City to his
parents HANNA B. ARUELO and LEONID D. ARUELO;
2. We know that the child’s parents is validly married on 20 December 2009 at

United PentecosalChurch,Ampayon,ButuanCity,solemnized by Rev.Ricardo
V. Casimiro;
3. We know that the child was assisted/ attended by Dra. MohayniSah-Nah

La Madali-Salacop, Attending Physician of BMC Hospital,Butuan City;
4. We know that the child was not yet immunized and baptized;
constraints;
facts of birth ofETHAN LEO BAKISKISAN ARUELO and to support the
IN WITNESS WHEREOF, we have hereunto set our hands this 24 October 2017
GINALYN CHUA MICAYABAS MELANIE MONTILLANO APAS

Affiant Affiant
Voter’s Identification Card PRC’s Identification Card
No. 0202-0279C-I1890GCM20000 No. 1467800
Issued by COMELEC,Butuan City Issued by City PRC, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017
x------------------------------------x
WE,MARILYN CALO BURDEOSandMARLOWE RIVERA LICAYANboth of

legal age, Filipinos, and are both residents of Purok 2, Brgy. Mahay,ButuanCity , all of
the Philippines, do hereby depose and state that:
1. We personally know ROY NELSON TAMBONG BOMBIO who was born on

18 June 1973 at Mahay, Butuan City to his parents GLORIA
ESCORPIONTAMBONG and NELSON PANGADLIN BOMBIO;
2. We know that his parents was validly married on 15 April 15 1978 at Saint
Joseph Cathedral, Butuan City solemnized by Rev. Fr. Alfonso Meyers, Catholic
Priest of the said Church;
3. We know that the child was assisted/ attended by Anecita L. Maylon,

Traditional Hilot of Brgy. Mahay, Butuan City;
facts of birth ofROY NELSON TAMBONG BOMBIO and to support the
IN WITNESS WHEREOF, we have hereunto set our hands this20
November2017 at Butuan City, Philippines.
MARILYN CALO BURDEOS MARLOWE RIVERA LICAYAN

Affiant Affiant
Voter’s Identification Card SSS Identification Card
No. 0202-0312A-A1161MCB20000 No. 08-2126489-2
Issued by COMELEC, Butuan City Issued by SSS, Butuan City
SUBSCRIBED AND SWORN to before me 20 November 2017 at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2017

x------------------------------------x
WE,RESTITUTA RODEMIO BAYETAandANGELYN P. ARAOARAOboth of

legal age, Filipinos, and are both residents of Purok Orchids II, and Purok 12 Cigla,
Brgy. Pagatpatanall ofButuan City of the Philippines, do hereby depose and state that:
1. We personally know the named CLARENCE ADLAON MARGALLOwho

was born on 31 August 2014 at Pagatpatan Birthing Clinic, Butuan City to his
parentsMARICEL GARCIA ADLAON and CERANDY GONZALES
MARGALLO;
3. 3. We know that the child was assisted/ attended by Isabelita M. Ladao,

Midwife of Brgy. Holy Redeemer, Butuan City;
facts of birth ofCLARENCE ADLAON MARGALLO and to support the
IN WITNESS WHEREOF, we have hereunto set our hands this08 January2018 at
RESTITUTA RODEMIO BAYETA ANGELYN P. ARAOARAO

Affiant Affiant
Voter’s Identification Card Employee’s Identification Card
No. 0202-0327A-E0159RRB20001-2 No. cos-018
Issued by COMELEC, Butuan City Issued by the City Government of Butuan
SUBSCRIBED AND SWORN to before me08 January 2018at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018
x------------------------------------x
WE,JOSELITO BARBERO MANULAT and EDISON CEDILLO BASAS both of

legal age, Filipinos, and a resident of Purok 1 Brgy. Bitan-agan and Purok 4, Brgy. Banza
1. We personally know child named SHEAN XYRIL YARO who was born on 11
August 2006 at Purok 23Lamosig,Brgy. Tungao, Butuan City to her mother
ANA MARIE QUINTO YARO;
2. We knowthat the child was born out of wedlock;
3. We know that the child’s birth was assisted/ attended by Adilaida P.

Mugao, Attending Hilot of Purok 21, Lamosig San Mateo,Butuan City;
4. We know that the said child was immunized but not yet baptized;
facts of birth of SHEAN XYRIL YARO and to support the application for
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 08 January 2018
JOSELITO BARBERO MANULAT EDISON CEDILLO BASAS

Affiant Affiant
Taxpayer’s Identification Card SSS Identification Card
No. 460-929-690-000 No. 09-1988735-6
Issued by BIR, Butuan City Issued by SSS, Butuan City
SUBSCRIBED AND SWORN to before me this 08 January 2018 at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x

1. We personally know child named KHIM NOEL YARO who was born on 17
April 2006 at Purok 21 Lamosig, San Mateo, Butuan City to her mother
NAOMI QUINTO YARO;

4. We know that the said child was immunized and baptized;
facts of birth of KHIM NOEL YARO and to support the application for
Butuan City.

Affiant Affiant
No. 460-929-690-000 No. 09-1988735-6

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x

1. We personally know child namedJONIL YARO GULLE who was born on 17

December 2010 at Purok 21 Lamosig, San Mateo, Butuan City to her mother
NAOMI QUINTO YARO AND GODOFREDO, JR. BULAWIN GULLE;

facts of birth of JONIL YARO GULLE and to support the application for
Butuan City.

Affiant Affiant
No. 460-929-690-000 No. 09-1988735-6

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.
x------------------------------------x
WE,GAVINO GONZALES BACORandDANILO LACHICA CENOboth of

legal age, Filipinos, and a resident of Brgy. Ampayon and Brgy. Golden Ribbon,
1. We personally know child namedJUSTINE CUPIN ZABATE who was born

on 06 August 2017 at Provincial Hospital, Agusan del Norte, Butuan City to his
parents JUVY ARROZA CUPIN and RODELIO JAVA ZABATE;
2. We knowthat the child parents were validly married on 27 August 2002 at

BirhensaKasilakMindnao Shrine Parish of Brgy. Bading, Butuan City
solemnized by Rev. Fr. Jose R. Sincero, Parochial Vicar of the said Church;
3. We know that the child’s birth was assisted/ attended by Dr. Benjamin Jr.
B. Selim, Medical Officer of the said Hospital;
4. We know that the said child was immunized but not yetbaptized;
facts of birth of JUSTINE CUPIN ZABATE and to support the application
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this16 January 2018
GAVINO GONZALES BACOR DANILO LACHICA CENO

Affiant Affiant
PhilHealth Identification Card HDMF Identification Card
No. 18-200240175-5 No. 1211-3221-4697
Issued by PhilHealth, Butuan City Issued by HDMF, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x
WE,RUEL CONCON CANATOYandMERLINDA JASPE LAHINAOboth of

legal age, Filipinos, and a resident of Purok 27, San Roque, Brgy. Tungao,Butuan
City,respectively all of Butuan City, after having been duly sworn to in accordance with
law do hereby depose and state that:
1. We personally know child named MILES ACANA LOGRONIO who was

born on November 16, 2017 at Tungao, Birthing Clinic, Brgy. Tungao, Butuan
City to her parents JERALYN GALARIO ACANA and LUSINO GALARION
LOGRONIO;
3. We know that the child’s birth was assisted/ attended by Lolita A.

Fiedacan, Midwife of the said Barangay;
4. We know that the said child was immunized but not yet baptized;
facts of birth of MILES ACANA LOGRONIOand to support the application for
Butuan City.
RUEL CONCON CANATOY MERLINDA JASPE LAHINAO

Affiant Affiant
Driver’s License Identification Card Taxpayer’s Identification Card
No. K01-14-001749 No. 470-367-501-000
Issued by LTO, Butuan City Issued by BIR, Butuan City
Valid until 2019-08-21

names.
Doc. №:________________;
Republic of the Philippines )B
Page №:________________;
Book №:________________;
Series of 2018.
x------------------------------------x
WE,TESSIE A. MORALESandMELOGIN MONDEJAR CASSIONboth of legal

age, Filipinos, and a resident of Purok 2B, Brgy. Bading and Purok 1, Brgy. Bobon,
1. We personally know child namedCRISJI YPARRAGUIRRE JALDO who was

born on 23 February 2012 at Butuan Medical Center, Km.5 Brgy. Baan, Butuan
City to his parents CRESTINE GUITES YPARRAGUIRRE and JIZON POTOT
JALDO;
3. We know that the child’s birth was assisted/ attended by Dr. Dorothy Joy
P. Macuno, Medical Officer III of the said Hospital;
facts of birth of CRISJI YPARRAGUIRRE JALDO and to support the
application for delayed registration of the same with the Office of the City
Civil Registrar, Butuan City.
TESSIE A. MORALES MELOGIN MONDEJAR CASSION

Affiant Affiant
PWD Identification Card Taxpayer’s Identification Card
No. 16-8600-000-0136 No. 269-812-372-000
Issued by CSWD, Butuan City Issued by BIR, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x
WE,DEVINA PEREZ BOQUILandMARIVIC ACERO BUSACOboth of legal

age, Filipinos, and a resident of both Purok 7, Brgy. Obrero,Butuan City, after having
been duly sworn to in accordance with law do hereby depose and state that:
1. We personally know child namedJHAN MARK S. GOMEZ who was born on

13 October 2017 at Butuan Medical Center, Km. 5, Brgy. Baan, Butuan City to
his parents JUVY SININING SALUDAR and VIGILOU SALADAGA GOMEZ;
2. We knowthat the child’s was born out of wedlock;
3. We know that the child’s birth was assisted/ attended by Dr.MohayniSah-

Nah La Madali-Salacop, Medical Officer of Butuan Medical Center, Butuan
City;
4. We know that the said child was already immunized but not yet baptized;
facts of birth of JHAN MARK S. GOMEZ and to support the application for
Butuan City.
DEVINA PEREZ BOQUIL MARIVIC ACERO BUSACO

Affiant Affiant
Philhealth Identification Card Philhealth Identification Card
No. 18-025233700-6 No. 18-050143769-5
Issued by PhilHealth, Butuan City Issued by PhilHealth, Butuan City
SUBSCRIBED AND SWORN to before me this28January 2018 at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.
x------------------------------------x
WE,JELYN LEYESVERTUDAZOandCORAZON L. BRENAboth of legal age,

Filipinos, and a resident of both Purok 21, Brgy. San Mateo, respectively all of Butuan
City, after having been duly sworn to in accordance with law do hereby depose and
state that:
1. We personally know the child name JOEY QUINTO YARO who was born
on 04 April 2000 at Purok 23, Brgy. Lamoseg, Tungao, Butuan City to his
parents PURITA MUGAO YARO and PEDRO LAMPADIO YARO;
2. We know that the child’s parents validly married on 10 February 1980 at

Tungao, Roman Catholic Church solemnized by Rev. Fr. Enrique Kuizon, Parish
Priest of the said Chuch;
3. We know that he was assisted/attended during his birth by Merlinda

Lahinao, Brgy. Hilot of Purok 27, Brgy. Tungao, Butuan City;
4. We know that he was already baptized and baptized;
facts of birth of JOEY QUINTO YAROand to support the application for
Butuan City.
JELYN LEYESVERTUDAZO CORAZON L. BRENA

Affiant Affiant
Voter’s Certificate 4P’sIdentification Card
No. 0202-0336B-I1993JLV20000 No. 160202076-0128-00060
Issued by COMELEC, Butuan City Issued by DSWD, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x
WE,SOBASCO SATERA EGHOT and JOSHUA YARO SUMO both of legal

age, Filipinos, and a resident of both Purok 6 MaputiBanaybanay, Brgy. Maputi and
Purok23,Brgy.Lamosig, respectively all of Butuan City, after having been duly sworn to
in accordance with law do hereby depose and state that:
1. We personally know the child name JOLLYMAR PONCANDOS who was

born on 13 August 1991 at Purok1 Gqalaxy, Brgy.Banza ,Butuan City to his
parents MARINA DIAMOS PONCADOS and TEODORO REVILLA
DAPLINI;
2. We know that the child is born out of wdlock;
3. We know that he was assisted/attended during her birth by Maria Leonora

T. Cupay, Brgy. Hilot of Purok 1 Galaxy, Brgy. Banza, Butuan City;
4. We know that he was already immunized but not yet baptized;
facts of birth of JOLLYMAR PONCADAS and to support the application for
Butuan City.
SOBASCO SATERA EGHOT JOSHUA YARO SUMO

Affiant Affiant
Voter’s Certificate Voter’sIdentification Card
No. 0202-0383B-J2488JYS10000-0 No. 2502-0056A-I1883SSE10000
Issued by COMELEC, Butuan City Issued by DSWD, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Republic
Series of 2018. of the Philippines )
x------------------------------------x
WE,ARMANDO SALAZAR UBALDOandJESSIE B. MARTINEZboth of legal

age, Filipinos, and both resident ofPurok2ABrgy. Sro. Niño, respectively all of Butuan
City, after having been duly sworn to in accordance with law do hereby depose and
state that:
1. We personally know the child nameDANILO OCHO PLISCO who was born
on 23 August 1960 at Baobaoan, Butuan City to his parents EMERENCIANA
BETANCOR OCHO and SIMEON DELOSO PLISCO;
3. We know that the child was assisted/attended by Cornelia Supas,Hilot of

the said barangay;
4. We know that the child was not immunized but baptized;
of birth of DANILO OCHO PLISCOand to support the application for delayed
registration of the same with the Office of the City Civil Registrar, Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this14 February 2018
ARMANDO SALAZAR UBALDO JESSIE B. MARTINEZ

Affiant Affiant
Senior’s Citizen Identification Card Senior’s Citizen’sIdentification Card
No. 11-24-16 No8600-19066-A
Issued by OSCA, Butuan City Issued by OSCA, Butuan City
SUBSCRIBED AND SWORN to before me this15 February 2018 at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x
WE,DARLIN APRIL DIAYON DELA PEÑAandJOSE ANTONIO (SEAN)

BOCATOT BAYOTASboth of legal age, Filipinos, and botha resident of Purok 5 Ube,
Brgy. Maonand Brgy. Baan Km. 3, respectively all of Butuan City, after having been
duly sworn to in accordance with law do hereby depose and state that:
1. We personally know the child named NEL VINCENT CAAYAMAN who was
born on 4 April 2013 at Sintos Subdivision Brgy. Villa Kananga, Butuan City to
his parents MARLYN CAAYAMAN and MARNEL MENDOZA BASAÑEZ;
3. We know that the child was assisted/attended byAdelinaAquadamBacoy,

Brgy. Hilot pf Purok 3, Sintos, Brgy. Villa Kananga, Butuan City;
4. We know that the child was already immunizedand baptized;
of birth of NEL VINCENT CAAYAMAN and to support the application for
Butuan City.
DARLIN APRIL DIAYON DELA PEÑA JOSE ANTONIO (SEAN) BOCATOT

Affiant BAYOTAS
Police Clearance Affiant
File No. 195421 Philhealth’sIdentification Card
Issued by PNP, Butuan City No.18-025134665-6
Issued by PhilHealth, Butuan City

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.
x------------------------------------x
WE,LORMINA MAUSISA TOMINAMANandGENIEN JOY E. ESPELITA bothof

legal age, Filipinos, and both a resident of Purok 11Brgy. 16 Ong Yiu and Brgy.
Doongan,Butuan City, after having been duly sworn to in accordance with law do
1. We personally know the child nameMCKEE BALANGHIG GAMUTAN who

was born on Purok 2, Brgy. Doongan, Butuan City to his parents MARICAR
NOLASCO BALANGHIG and KENNETH EVALLE GAMUTAN;
3. We know that the child was assisted/attended by Gloria S. Dasig, Midwife

of the said Barangay Doongan, Butuan City;
4. We know that the child was already immunize but not yet baptized;
of birth of MCKEE BALANGHIG GAMUTAN and to support the application
Butuan City.
LORMINA MAUSISA TOMINAMAN GENIEN JOY E. ESPELITA

Affiant Affiant
PhilHealth Identification Card PhilHealthIdentification Card
No .18-025275849-4 No .18-025194646-7
Issued by PhilHealth, Butuan City Issued by PhilHealth, Butuan City

Doc. №:________________;
Philippines.Affiants
exhibited their identification cards as stated below their respective
Page №:________________;
names.
Book №:________________;
Series of 2018.

x------------------------------------x
WE,LUZ TABADA SANCHEZ andJENEFFER A. GOYO both of legal age,
1. We personally know ZANDRO DALE QUIJANO GALE who was born on 14

April 2013 at Purok-18 Brgy. Tungao,Butuan City to his parents ROWENA
BURIAS QUIJANO and ALEJANDRO OCAMAS GALE JR. ;
3. We know that the child was assisted/attended by Esther

Betonio,BarangayHilot;
4. We know that the child was not immunize and baptized;
of birth of ZANDRO DALE QUIJANO GALE and to support the application
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 19 February 2018
LUZ TABADA SANCHEZ JENEFFER A. GOYO

Affiant Affiant
UMID Identification Card Driver’s LicenseIdentification Card
No. 006-0068-16514-9 No K01-0671374
Issued by SSS, Butuan City Issued by LTO, Butuan City
SUBSCRIBED AND SWORN to before me this 19 February 2018 at Butuan City,

names.
Doc. №:________________;
Page №:________________;
Book №:________________;
Series of 2018.

x------------------------------------x
We, LOLITA RICO ELARCOSA and JOSEFINA PEREZ DIGNOS, both

of legal age, Filipinos and all residents Purok-15, Upper Mandacpan, Butuan City, and
Purok-20, San Vicente, Butuan City, after having been duly sworn to in accordance with
law, do hereby depose and state that:
1. We personally know the child named MELCHIE BARCELONA PEREZ who

was born on August 15, 1997 at Langihan City Hospital to her parents ROSALIE
CABALDE BARCELONA and MELCHOR BAGNOL PEREZ;
3. We know that the child was assisted/attended by Dr. Mary Joy, of

Langihan City Hospital, Butuan City;
of birth of MELCHIE BARCELONA PEREZ and to support the application for
Butuan City.
IN WITNESS WHEREOF, we have hereunto set our hands this 04 July 2018 at
LOLITA RICO ELARCOSA JOSEFINA PEREZ DIGNOS

Affiant Affiant
PhilHealth ID Voter’s ID
No. 18-025049887 No. 0202-0351B-C2366JPD20001-0
Issued in, Butuan City Issued by COMELEC, Butuan City
SUBSCRIBED AND SWORN to before me this 04 July 2018 at Butuan City,

names.
NOTARY PUBLIC
Doc. №:________________;
Page №:________________; UNTIL DECEMBER 31, 2018
Book №:________________; ROLL NO. 67176 (5-24-2017)
Series of 2018. IBP NO. 1061836 (1-3-18) B.C
PTR NO. 1454141 (1-4-18) B.C
TIN: 000-319-198-979

Suico JOINT

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Suico JOINT

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Republic of the Philippines )

Butuan City…………………) SS.

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, CAROLINE BEJARANG SIMAN and WILLIAM PAUL GALEMBA JAMERO

2. We know that the child was born out of wedlock;

3. We know that the child’s birth was assisted/attended by Florencia Caberte,

CAROLINE BEJARANG SIMAN WILLIAM PAUL GALEMBA JAMERO

ATTY. GLAIZA MAE L. LAGUNDE

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE,ANGELA MAE ESPINA ARRIOLA and KATRINA FAJARDO

1. We personally knowthe child named AARON JAMES SERATE

2. We know that the child was born out of wedlock;

4. We know that the child was already immunized andbaptized;

IN WITNESS WHEREOF, we have hereunto set our hands this 07 June2018 at

ANGELA MAE ESPINA ARRIOLA KATRINA FAJARDO BUDLONG

SUBSCRIBED AND SWORN to before me this 07 June 2018at Butuan City,

ATTY. GLAIZA MAE L. LAGUNDE

WE, GIENEN JOY E. ESPELITAandMAY SHAYNE R. DOLERAboth of legal

1. We personally know the child named AKIHIRO EIJI CABILAN

2. We know that the child was born out of wedlock;

4. We know that the child wasalready immunized but not yetbaptized;

GIENEN JOY E. ESPELITA MAY SHAYNE R. DOLERA

ATTY. GLAIZA MAE L. LAGUNDE

WE, RODOLFO BARRIENTOS SUMANDURANandVICKY PANDITA

1. We personally know the child namedMARY ROSE MOSO TALIBONGwho

2. We know that the child was born out of wedlock;

3. We know thather birth was assisted/ attended by Juanita Matilos, Hilotof

4. We know that the she wasalready immunized and baptized;

RODOLFO BARRIENTOS VICKY PANDITA BERUAN

ATTY. MICHELLE M. EVANGELIO

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, LEONIDA LAYON CASTAÑARESandADRIAN LAYONCASTAÑARES

1. We personally know the child namedJIAN DAVE BONGAY GONZALES

2. We know that the child’s parents validly married on 28 September 2018 at

4. We know that the child was immunized and baptized;

SUBSCRIBED AND SWORN to before me 07 February 2018 at Butuan City,

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, ABEGAIL TIOAQUEN MATURANandJENNIFER AVENIDO

1. We personally know the child namedZEPHIA TRIXIA CYCILLE ATAZAN

4. We know that the child was immunized and baptized;

SUBSCRIBED AND SWORN to before me 01 June 2018 at Butuan City,

ATTY. MICHELLE M. EVANGELIO

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, DONATO S. LAMBONAOandPERFECTO O. MOCAboth of legal age,

1. We personally know the child namedALBERT ESARSA PAG-ONG who was

3. We know that hisbirth was assisted/ attended by Dr. TeresitaBusico,

4. We know that he was baptized;

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, JENNIFER A. SILVOSAandWELMA MOLDE ENTONGboth of legal age,

2. We know that the child’swas born out of wedlock;

3. We know that his birth was assisted/ attended by Lourdes B. Mao,

Republic of the Philippines )

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, ROSEJANE ATEGA ARRIOLA andJHEAN CENIZA FLOREZboth of legal

1. We personally know the child SHELIT RECAÑA whowas born on 11

2. We know that the child’s was born out of wedlock;

3. We know that his birth was assisted/ attended by DOCTOR MAURINE C.

Republic of the Philippines )

JOINT AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, ELIZABETH F. MALBAS and FREDDIE M. SULLANO both of legal age,

1. We personally know child named CALLEB JOHN POTESTAS APARTE who

ELIZABETH F. MALBAS FREDDIE M. SULLANO