Affidavit of Surviving Spouse

I, _______________________________, Filipino, of legal age, widow/widower, with address at ____________________ and the following contact number ____________________, after having sworn in accordance with law, hereby depose and state:

I am a widow/widower of ____________________ who was a GSIS member/retiree who died on ____________________ at ____________________;

I hereby declare that, since the death of my spouse, I have not remarried, cohabited with another person, or otherwise engaged in a common-law relationship. I acknowledge that, if granted, my entitlement to survivorship benefit from the GSIS will automatically and permanently terminate the moment that I re-marry, co-habit with any person/engage in a common-law relationship, whether of the same or opposite sex, or, whether or not such a relationship is still subsisting. I hereby agree unconditionally to reimburse/return to the GSIS, without need of demand or judicial action, all survivorship benefits I may still unduly receive after my entitlement thereto is terminated as stated above.

Pursuant to and consistent with the declaration I made above, I hereby authorize the GSIS to secure information regarding my civil status from the National Statistics Office (NSO) or other relevant government offices or even private entities.

I am executing this affidavit to attest to the truth of the foregoing statements in support of my application for survivorship benefit with the GSIS under Republic Act No. 8291 and for other legal purposes it may serve. I fully understand that any inaccurate and untruthful statement in this affidavit shall render me criminally and civilly liable.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

___________________________________

Affiant

Affidavit of Buyer/Transferee

I_________________, of legal age, single/married/widow, Filipino citizen, and presently residing at _____________________, after having been duly sworn to in accordance with law, do hereby depose and say:

  1. That I am the VENDEE of a parcel of land located at Brgy. Bilaran, Nasugbu, Batangas with an area of THIRTY FIVE THOUSAND ONE HUNDRED (35,10000) square meters, more or less, covered by Original Certificate of Title No. 954154;
  2. That I acquired the said parcel of land from PEDRO B. DE LA CRUZ as evidenced by a Deed of Absolute Sale entered in the notarial register of Notary Public Atty. Maria C. Gonzalez dated December 15, 2013 at Nasugbu under Doc. No. 2; Page No. 3; Book No. IV; Series of 2013;
  3. That this affidavit is being executed in compliance with DAR Administrative Order No._____, Series of ______ as well as to show proof that my total aggregate landholding inclusive of the land subject of the above-mentioned transaction does not exceed five (5) hectares;
  4. That I am executing this affidavit to attest to the truth of the foregoing facts and for whatever legal intents and purposes that it may legally serve;

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

___________________________________

Affiant

Affidavit of Undertaking for Terminal Leave

I, _______________________________, of legal age, Filipino, single/married/widow/widower and a resident of ___________________________ after having been duly sworn to in accordance with law, hereby voluntarily depose and say:

  1. That I am presently employed in the Commission on Audit and due for compulsory/optional retirement on ______________________________.
  2. That I have applied for Terminal Leave effective _______________________.
  3. That pre-audit of financial transactions of national government agencies, among others, has been lifted per COA Circular 2011-002 dated July 22, 2011.
  4. That should it appear in post-audit there was overpayment in the money value of my terminal leave, I am willing to refund of any excess amount thereon;
  5. That on the other hand, if it will appear in post-audit that I was underpaid in my terminal leave benefits, it is understood that the Commission on Audit shall pay me the difference of the amount corresponding to the underpayment; and,
  6. That I am executing this affidavit to attest to the truth to all the above facts.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

___________________________________

Affiant

Affidavit of Undertaking for Terminal Leave (Survivorship)

Republic of the Philippines )

_____________________ ) SS.

x- – – – – – – – – – – – – – – – – – – – – x

AFFIDAVIT OF UNDERTAKING FOR TERMINAL LEAVE (Survivorship)

I, _______________________________, of legal age, Filipino, __________________ and a resident of ___________________________ after having been duly sworn to in accordance with law, hereby voluntarily depose and say:

  1. That I am the __________________ of the late ________________________ who passed away on ___________________ at _____________________________ and that at the time of his/her death was presently employed in the Commission on Audit.
  2. I am applying for Terminal Leave on his/her behalf effective _______________________________.
  3. That pre-audit of financial transaction of national government agencies, among others, has been lifted per COA Circular 2011-002 dated July 22, 2011;
  4. That should it appear in post-audit there was overpayment in the money value of his/her terminal leave benefits, I am willing to make refund of any excess amount thereon;
  5. That on the other hand, it will appear in post-audit that he/she was underpaid in his/her terminal leave benefits, it is understood that the Commission on Audit shall likewise pay him/her the difference of the amount corresponding to the underpayment; and
  6. That I am executing this affidavit to attest to all above facts.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

___________________________________

Affiant

Affidavit of Undertaking

I, Name of mother and/or other proposed custodian of the child, of legal age, married, with residence and postal address at ____________________________, Manila, after being duly sworn to in accordance with law, hereby depose and say:

  1. I am the mother/father of Name of child, 15 years old, who is charged with Viol. of PD 1619 before the City of Manila, Regional Trial Court (Br. 43);
  2. The above named child is under my custody and care at the time of his arrest allegedly for the said offense;
  3. I am ready and willing to assume and fulfill my duty and responsibility to supervise and guide the said child during his release on recognizance pursuant to the provisions of the Child and Youth Welfare Code and the Family Courts Act of 1997;
  4. I am likewise solemnly promising and undertaking before this Honorable Court to produce and present the said child before this Honorable Court whenever required to do so during the pendency of the above-cited case in order to answer for the said charge.

WHEREFORE, in order to attest to the truth of the foregoing, I am hereby affixing my signature to this Affidavit of Undertaking this ______ day of _________, 20____ in _________.

(Sgd.) Name of mother and/or proposed custodian

Affiant

Affidavit of Witness

I, ___________________, of legal age, Filipino, (single/married/widow) and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state:

  1. That I was present and personally saw that accused, __________, committed the crime of _______________________ against the victim __________________;
  2. That ___________________________ (State other circumstances and the relation either to the victim or accused or both);
  3. That ___________________________ (State the details of the acts committed by the accused against the victim);
  4. That ___________________________ (State the acts done by the witness and the reason thereof);
  5. That I executed this affidavit to attest the truthfulness of the foregoing facts and to support the filing of criminal case against ____________________ for violation of ________________________.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

Affidavit to Use the Surname of the Father

I_________________, of legal age, single/married/widow, Filipino citizen, and presently residing at _____________________, after having been duly sworn to in accordance with law, do hereby depose and say:

  1. That I am the biological father of _________________.
  2. That the biological mother of the child is _________________.
  3. That my child _________________ was born on __________ ____, _____ at _________________.
  4. That the facts of birth of my child were duly registered at the Office of the __________ Civil Registrar.
  5. That I, _________________ being the father of _________________, hereby acknowledged and recognized him as my child and legal heir.
  6. That I am allowing my child _________________ to use my surname _________________ to be his surname in his Certificate of Live Birth.
  7. That I execute this affidavit to attest to the truth of the above facts in compliance with the provisions of Republic Act No. 9255.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ___________ 20____ in ____________, _____________, Philippines.

Affidavit of Undertaking as Custodian

I, ______________  , Filipino, of legal age, single/married/widow/widower, and a resident  of ____________ , after having been duly sworn to in accordance with law, depose and state, that:

    1. I am    the    incumbent   Punong Barangay  of  Barangay                                 ,   _____     City;
    2.                        is one of the residents of our barangay;
    3. I was informed that                                has  applied  for  probation  having  been convicted for the crime of                                                                      by the                              Trial Court of                   , Branch        _, and docketed as Criminal Case No.                         ;
    4. I was further made to understand that desires to be released on recognizance pending the resolution of her application for probation, and needs a custodian for this purpose;
    5. I hereby agree to be the said custodian of and undertakes to bring him to court whenever required;
    6. I am executing this affidavit to apprise all those concerned of foregoing facts and for whatever other legal purpose it may serve.

 

 Affiant

SUBSCRIBED AND SWORN to before me this           day of                                    , at                   , Philippines. The identity of the affiant is established by his Philippine Passport No.                           _, issued on_                    .

Joint Affidavit of Correction of Name Two Disinterested Person

WE, __________ and _________ both of legal ages, Filipino and with residence addresses at __________ and _________, respectively, after having been jointly sworn to in accordance with law do hereby depose and state, that:

  1. We personally  know  the  person  of                                               who  was  born  on                                    at                                                                                ;
  2. It was discovered lately that his/her NAME / MIDDLE NAME / FAMILY NAME / DATE OF BIRTH /PLACE OF BIRTH,                           , was               erroneously entered as                                                    in his/her                                                 (document);
  3. The true  and  correct  NAME  /  MIDDLE  NAME  /  FAMILY  NAME  /  DATE  OF BIRTH/PLACE OF BIRTH is/are _____________  ;
  4.                                                 and                                              refer to one and the same person;
  5. That we are executing this affidavit to attest to the foregoing narration of facts and for whatever legal purposes and intents this may serve.IN TESTIMONY WHEREOF, WE have hereunto affixed our signatures this ________  day of ___________ at                                           , Philippines.

    Affiant                                                                   Affiant

Affidavit of Indigency

I, _____________of legal age, single/married to _____________________________and residing at  _______________ and having been duly sworn in accordance with law, depose and say:

1. That I desire to avail of the free legal service of the Public Attorney’s Office.

2. That my monthly net salary/income is P _________________.

3. That I am executing this affidavit to entitle me to the desired legal services.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______________ day of ____, 20 _______, in the City/Municipality of _________ , Province of ___________.