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Affidavit for Birth Certificate Request

Josefina Capili Florentino executed an affidavit to request her deceased brother Samson Capili's birth certificate from the Philippine Statistics Authority office in Tuguegarao City. She stated that Samson died without a wife or children who could give her authority to secure the document. Their parents have also passed away and cannot provide consent. Josefina signed the affidavit to attest to the truthfulness of her request to obtain a copy of Samson's birth certificate.

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15 views1 page

Affidavit for Birth Certificate Request

Josefina Capili Florentino executed an affidavit to request her deceased brother Samson Capili's birth certificate from the Philippine Statistics Authority office in Tuguegarao City. She stated that Samson died without a wife or children who could give her authority to secure the document. Their parents have also passed away and cannot provide consent. Josefina signed the affidavit to attest to the truthfulness of her request to obtain a copy of Samson's birth certificate.

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Atlas LawOffice
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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REPUBLIC OF THE PHILIPPINES )

CITY OF TUGUEGARAO )S.S


PROVINCE OF CAGAYAN )

AFFIDAVIT

I, JOSEFINA CAPILI FLORENTINO, of legal age, Filipino and a resident of


AFUSING, Daga Alcala, after having been duly sworn in accordance with law,
do hereby depose and state:

1. That I went at the Office of the Philippine Statistic Authority,


Tuguegarao City to request for the issuance of birth certificate of my
brother SAMSON CAPILI who died on April 10, 2018;
2. That before I could secure said document, the Office have asked me to
execute a Special Power of Attorney;
3. However, records show that SAMSON CAPILI died without any wife or
children who could give me their authority to secure the same;
4. Moreover, our parents, EMILIANO CAPILI and INNOCENCIA APOSTOL-
CAPILI, have already died and therefore cannot give their consent
appurtenant thereto;
5. Hence, I am executing this Affidavit to attest to the truthfulness and
veracity of the foregoing and to support my request to secure a copy of
my brother’s birth certificate SAMSON CAPILI;

IN WITNESS WHEREOF, I have hereunto set my hand this


____________________ at Tuguegarao City, Cagayan.

JOSEFINA CAPILI FLORENTINO


Affiant

SUBSCRIBED AND SWORN to before me this ________________________ by


affiant who exhibited to me her OSCA ID with Control No. 17-08-4756 as
competent proof of her identity.

Doc No.______:
Page No._____:
Book No._____
Series of 2018.

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