AFFIDAVIT OF TWO DISINTERESTED PERSONS

(JOINT BIRTH AFFIDAVIT)

We, ______________________________________, ___________________

citizen, of legal age, and with residence at
___________________________________________________________________
and _________________________________________, ______________________
citizen, of legal age, and with residence at
___________________________________________________________________,
after having been duly sworn in accordance with law, hereby depose and say:

1. That we personally know __________________________________ and

________________________________________ as the parents of:

NAME DATE AND PLACE OF BIRTH

____________________________ _______________________________
____________________________ _______________________________

2. That we also know their child/children

________________________________________________________________
and have known him/her/them since _________________________.

3. That we are not related by consanguinity or affinity to the child’s parents;

4. That we are executing this Affidavit not for any remuneration whatsoever but to
attest to the truth and veracity of the foregoing statements in connection with the
registration of the birth of the above-mentioned child/children with the Philippine
authorities.

FURTHER AFFIANTS SAYETH NAUGHT.

IN WITNESS WHEREOF, we hereby affix our signatures this _____ day of

__________________________ in ____________________, Saudi Arabia.

____________________________ ____________________________
Affiant Affiant
Passport no.: _________________ Passport no.: _________________
Contact no.: ___________________ Contact no.: ___________________

x--------------------------------------------------------------------------------------------------------------------------------------x
FOREIGN SERVICE OF THE PHILIPPINES )
Consulate General of the Philippines ) S.S.
Jeddah, Kingdom of Saudi Arabia )

SUBSCRIBED AND SWORN TO before me this ____ day of _____________________ 20___ at the
Philippine Consulate General, Jeddah, Kingdom of Saudi Arabia.

Doc. no. : __________

Service no. : __________
Series of : __________ __________________________
O.R. no. : __________ Administering Officer
Date : __________