REPUBLIC OF THE PHILIPPINES )

CITY OF CALBAYOG ) S.S.

AFFIDAVIT OF RECONSTRUCTION OF MARRIAGE CERTIFICATE

I, CLODUALDO P. YBAÑEZ, of legal age, Filipino, and resident of Brgy. Balud, Sta.
Margarita Samar, after having been duly sworn to in accordance with law, hereby depose and
say;

That I personally know the person whose circumstances are mentioned below, to wit:

SPOUSES’ NAME : LEONARDO SARZATA

Wife Address
Husband Address
Date of Marriage
Place of Marriage
Solemnizing Officer
Spouse Nationality
Parents of the Husband
Parents of the Wife
Witnesses
CHARITA CASTILLO
: Sta. Margarita Samar
: Tinambacan District, Calbayog City
: June 1, 1972
: Office of the Municipal Mayor, Sta. Margarita Samar
: Municipal Mayor Atty. Antonio T. Gan, CPA
: Filipino citizens
: Antonio Sarzata and Gorgonia Amparado
: Alberto Castillo and Potenciano Morallo
: Jesus D. Castillo and Maria de los Santos

That I am executing these facts to attest the veracity of the circumstances of the above
named person for reconstruction of their marriage certificate for whatever legal purpose it may
serve, since, the fact of their marriage was not entered in the marriage register or was destroyed
by the elements beyond human control.

That I purposely executed this affidavit in the absence of any records, either public or
private and in order that the same maybe used by their in the application for late registration of
their marriage.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of __,2021 at
Calbayog City, Samar, Philippines.

CLODUALDO P. YBAÑEZ
Affiant

SUBCRIBED AND SWORN to before me this ___ day of ___2021, in Calbayog City,
Samar, Philippines affiant exhibited to me his OSCA No. 2193 issued on 03-21-17 as competent
proof of his identity.
REPUBLIC OF THE PHILIPPINES )
CITY OF CALBAYOG ) S.S.

JOINT AFFIDAVIT
Re- construction of baptismal certificate

We, NORMA RECAMARA LAZARO and ALFREDA RAZ MEJARITO, both of

legal age, Filipinos and both resident of Brgy. Palale, Sta Margarita, Samar, after having been
duly sworn to according to law, hereby depose and state:

That we personally know the person whose circumstances are mentioned below, to wit:

Name : JINEVA S. FONTAMILLAS

Date of Birth : JAN. 22, 1996
Place of Birth : BRGY. PALALE, STA MARGARITA, SAMAR
Date of Baptism : JULY 30, 1996
Place of Baptism : SEÑIOR SAN IGNACIO DE LOYOLA PARISH
Mother : LUZ SANTIAGO
Father : REYNALDO FONTAMILLAS
Officiating priest : REV. FR. LITO CAPEDING
Godparents : 1.VILMA SANTIAGO
2.DODOY CORALAN

That we are both executing these facts to attest the veracity of the circumstances of the
above named person for reconstruction of her baptismal certificate for whatever legal purpose it
may serve. Since, her facts of baptism was not entered in the baptismal register or was destroyed
by the elements beyond human control.

That we purposely executed this affidavit in the absence of any records, either public or
private and in order that the same maybe used by her in her application for late registration of her
birth.

IN WITNESS WHEREOF, We have hereunto set my hand this ___ day of __,2019 at
Calbayog city, Samar, Philippines.

NORMA RECAMARA LAZARO ALFREDA RAZ MEJARITO

 Affiant Affiant
Ctc: 29700010 ctc: 29700014

SUBCRIBED AND SWORN to before me this ___ day of ___2019, in Calbayog City,
Samar, Philippines.