Affidavit of COHABITATION

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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF DAVAO DEL NORTE ) S.S.


CITY OF TAGUM )

JOINT AFFIDAVIT OF COHABITATION

We, JERSON REVELLEZA SUPERALES, and LENNY PACIENTE SAMENTAR,


both Filipinos, of legal age, and residents of PuroK 3-A, Elizalde, Maco, Davao de Oro,
Philippines, after being duly sworn to in accordance with law hereby depose and say:

1. That we have been living together as husband and wife under the same roof,
continuously and without any interruption, since April 10, 2011 until the present time
or a period of more than Eleven (11) years;
2. That during our cohabitation and even until the present, we remain both of single
status without any legal impediment to marry each other;
3. That during our cohabitation, we were blessed with TWO (2) children whom we
named CHARLES JHON SAMENTAR SUPERALES who was born on October 3,
2011 and CHESKHA SAMENTAR SUPERALES who was born on December 07,
2014;
4. That we are executing this affidavit to attest to the truth of the foregoing facts and for
the purposes of contracting marriage without the need of securing the marriage
license pursuant to the provisions of Article 34 of the Family Code of the Philippines.

IN WITNESS WHEREOF, we have hereunto set our hands this 13 th day of September,
2022, in Tagum City, Davao del Norte, Philippines.

JERSON REVELLEZA SUPERALES LENNY PACIENTE SAMENTAR


PDL No. L06-15-006289 National Id. No. 4034-1306-4351-6578
Affiant Affiant

SUBSCRIBED AND SWORN to before me this 13 th day of September, 2022, in Tagum


City, Davao del Norte, Philippines.

Doc. No. 107 ;


Page No. 22 ;
Book No. IV ;
Series of 2022.

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