REPUBLIC OF THE PHILIPPINES )

PROVINCE OF AGUSAN DEL NORTE )

CITY/MUNICIPALITY OF CABADBARAN S.S. )
X----------------------------------------------- )

AFFIDAVIT OF LATE REGISTRATION OF BIRTH WITH CORROBORATION

I, RICARDO MATURAN ABARICO, Filipino, of legal age, single, and resident of Baan,
Butuan City, Philippines, after having been duly sworn to in accordance with law, hereby
depose and state that:

1. I am RICARDO MATURAN ABARICO and was born in CABADBARAN CITY,

AGUSAN DEL NORTE, PHILIPPINES, on the 29TH day of JUNE, 1957;

2. That the reason of my late registration is the belief that my birth has been registered by
my parents, when in fact it was not;

3. As such, I execute this Affidavit to certify or attest to the truth of the foregoing facts
and to support my delayed registration of birth.

IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of September, 2017, in
Cabadbaran City, Agusan del Norte, Philippines.

RICARDO MATURAN ABARICO

Affiant
VIN 0202-0207E-G2957RMA10000-8

CORROBORATION

We, ALMANSOR YUTIAMCO and JERRY VESTIL, both of legal ages, Filipinos,
married and both residents of Cabadbaran City, Agusan del Norte, Philippines under oath and
say:

That we personally know RICARDO MATURAN ABARICO, who was born on June 29,
1957 at Cabadbaran, Agusan del Norte, and that he is the child of SEGUNDO ESTALANE
ABARICO and ROSITA SEMBLANTE MATURAN, that all foregoing statements are true and
correct to the best of our knowledge.

ALMANSOR YUTIAMCO JERRY VESTIL

Affiant Affiant
LGU ID No. EN-46 LGU ID No. EN-51

SUBSCRIBED AND SWORN before me in Cabadbaran City, Agusan del Norte, Philippines this
8th day of September, 2017 affiants who exhibited to me their competent evidence of identity.

Doc. No. ____;

Page No. ____;
Book No. I;
Series of 2017.