Affidavit of Pendency/Non-Pendency of Administrative/Criminal Case (survivorship)

Affidavit of Pendency/Non-Pendency of Administrative/Criminal Case (survivorship)

Use this free template – Affidavit of Pendency/Non-Pendency of Administrative/Criminal Case (survivorship). This affidavit declares that there is no administrative/criminal case pending against the affiant in any forum.

To use this complimentary template, simply fill out the blank spaces and edit the document with the relevant information, print it out, and sign below.

I, _______________________________, of legal age, Filipino, widow/widower, and with permanent address at ___________________________ after having been duly sworn to in accordance with the law, hereby voluntarily depose and say:

1. That my husband/wife was employed as _________________________at the Commission on Audit prior to his/her death on ____________________;

2. That I am applying for Survivorship benefits effective ___________;

3. Pls. check [√] appropriate box

________ That there is no pending administrative or criminal case filed against me in any forum

________ That there is a pending case against me, details of which are as follows:

________ Administrative ________ Criminal

Nature/specific offenses charged: _______________________________

4. That I am executing this affidavit to attest to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have set my hand and affixed my signature this _________ day of ______________, 20 ______ at _______________________.

_______________________________
Affiant

If you found this template for Affidavit of Pendency/Non-Pendency of Administrative/Criminal Case (survivorship) useful, you might also be interested in: Affidavit of Low Income