Republic of the Philippines )

City of Cagayan de Oro ) Ss.

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AFFIDAVIT OF TWO DISINTERESTED PERSONS

We, CLEOMINIX TIEMPO SALADORES and JERRY AQUINO Filipinos, of

legal age and residents of Nasipit, Agusan del Norte, upon our oath, do hereby
depose and state – That:

1. We are long-time friends of GUIA GENIFONA RIARTE DOYON and her

family.
2. She was admitted to Polymedic Velez Hospital last April 10, 2018 under
the same name.
3. It was however discovered that the name on her Philhealth Records is
still not updated by her employer’s HR department. Hence, the name
GUIA GENIFONA DELA RIARTE DOYON-ORTEGA, the name she carried
prior to the annulment of her previous marriage appears in the
Philhealth Records.
4. As Guia’s friends, we know for a fact that her full and correct name is
GUIA GENIFONA DELA RIARTE DOYON and not GUIA GENIFONA DELA
RIARTE DOYON-ORTEGA.
5. The name GUIA GENIFONA DELA RIARTE DOYON, in her personal
identification cards, and GUIA GENIFONA DELA RIARTE DOYON-
ORTEGA, the name in her Philhealth records both refer to one and the
same person.
6. We are executing this affidavit to attest to the truth of the foregoing and
for whatever legal purpose it may serve.

IN WITNESS WHEREOF, We hereunto affix my signature this April 13,

2018, City of Cagayan de Oro, Philippines.

CLEOMINIX TIEMPO SALADORES

JERRY AQUINO

Affiants

SUBSCRIBED AND SWORN to before me this April 13, 2018 in Cagayan de

Oro City, affiants exhibiting to me the following:
NAME IDENTIFICATION DATE/PLACE OF ISSUE
CLEOMINIX TIEMPO SALADORES
PRN L63170547612 8/17/17/ Butuan
City,Agusan
JERRY AQUINO

I certify that I have examined Affiants and I am satisfied that they had voluntarily executed the
foregoing Affidavit and that the contents thereof had been fully explained and understood
by them before they affixed their signatures thereon.

Doc. No.
Page No.
Book No.
Series of 2017.