Republic of the Philippines

Province of Leyte
MUNICIPALITY OF TANAUAN

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) s.s.
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JOINT AFFIDAVIT
OF LATE REGISTRATION OF FACT OF BIRTH
We, RODELLE E. MACEDA and NARIAN MAE COMPETENTE, both of
legal ages, Filipinos, married, residents of Tanauan, Leyte, and municipal
employees of LGU-Tanauan, Leyte, after having been duly sworn according to law,
hereby depose and say; THAT:
1. We know personally the spouses namely; ALBERTO M. COPINO and
DEBBELYN C. MARTILLO of Brgy. Maghulod, Tanauan, Leyte, being our
close friends;
2. We are fully aware of the fact that during the time of their union as commonlaw husband and wife, the said unmarried couple begot a female child whom
they named as she was baptized with the name RACHELLE DENIEL M.
COPINO who was born on March 18, 2011 at Palo, Leyte;
3. That the fact of birth of RACHELLE DENIEL M. COPINO, however, was not
registered with the office of the Local Civil Registrar within the reglementary
period due to inadvertence;
4. We have freely and voluntarily executed the foregoing affidavit without any
mental reservation or purpose of evasion nor to defraud third persons but to
attest to the veracity of foregoing narration of fact of birth and to support the
late registration of the birth of the above-mentioned daughter of the spouses,
ALBERTO M. COPINO and DEBBELYN C. MARTILLO of Brgy. Maghulod,
Tanauan, Leyte, and for whatever legal purposes it may serve.
IN WITNESS WHEREOF, we have hereunto set our hands this 20 th day of November
2015 at Tanauan, Leyte, Philippines.

RODELLE MACEDA
Affiant

NARIAN MAE COMPETENTE

Affiant

SUBSCRIBED AND SWORN to before me this ________________________

at Tanauan, Leyte, Philippines.