REPUBLIC OF THE PHILIPPINES )

CITY OF BAGUIO ) S.S.

AFFIDAVIT OF GUARDIANSHIP
I, Samantha S. Co, of legal age, widower, and residing at No. 7 Bokawkan Road, Baguio
City, Philippines, after having been duly sworn to in accordance with law, hereby depose and
state:
1. That I am the mother of my daughter Laila S. Co by my deceased wife, Tony T. Co who
died on November 20, 2013;
2. That by reason of the death of my above-named husband, I henceforth become the
mother and guardian of my said daughter as she is still a minor having been born on
March 2, 2010;
3. That I am executing this affidavit in order to attest to the truth of the foregoing
circumstances and for the purpose of securing an educational insurance for my said
daughter in my capacity as her guardian.
IN WITNESS WHEREOF, I have hereunto set my hand this 27
th
day of June, 2014 in
the city of Baguio, Philippines.

______________________
Samantha S. Co
AFFIANT

SUBSCRIBED AND SWORN to before me, this 27
th
day of June, 2014, by the Affiant
who exhibited to me her Drivers License No. 199993 issued at Baguio City on October 21, 2011.