REPUBLIC OF THE PHILIPPINES )
City of ____________________ ) S.S.
AFFIDAVIT OF CONFIRMATION
I, (NAME OF AFFIANT), Filipino, of legal age, married/single, and a resident of (Place of Residence of Affiant), a bona fide member of the Philippine National Police with the rank of SENIOR POLICE OFFICER 3 and presently assigned at Police Regional Office 7 (PRO-7) after having been duly sworn to in accordance with law, do hereby depose and says – THAT:
1. Pursuant to this affidavit, I am confirming that the following are my legal beneficiaries and/or heirs, to wit:
|
NAME |
RELATIONSHIP |
BIRTHDATE |
|
|
HUSBAND / WIFE |
|
|
|
SON |
|
|
|
DAUGHTER |
|
2. My relationship with the above-stated persons are borne out by the fact that I am the lawful spouse and the legitimate/illegitimate father/mother of the afore-named children as evidenced by the attached advisory on marriages, marriage contract and birth certificates;
3. I hold myself criminally and administratively liable for perjury and dishonesty should any statements made herein are inaccurate or later found to be false and in of law.
AFFIANT SAYETH NAUGHT. Signed this (Date of Signing) at (Place of Signing).
(NAME OF AFFIANT)
Affiant
SUBSCRIBED AND SWORN to before me this (Date of (Notarization) at (Place of Notarization), Philippines, affiant exhibited to me his/her (ID Details) as competent proof of identity.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of _____.
