REPUBLIC OF THE PHILIPPINES

CITY OF CALAPAN, PROVINCE OF

ORIENTAL MINDORO

AFFIDAVIT OF CONFIRMATION

I, SPO1 DANIEL MATSUNAGA, a Filipino of legal age, a resident of #268,

Ilang_Ilang St. Pangarap Village, Caloocan City, a bona fide member of the Philippine National
Police with the rank of SPO1 and presently assigned at Regional Headquarters Support Group,
(RHSG) MIMAROPA PRO 4B, Camp Efigenio C. Navarro, Calapan City, Oriental Mindoro after
having been duly sworn to in accordance with the law, do hereby depose and say that:
1. Pursuant to this affidavit, I am confirming that the following are my legal beneficiaries
and/or heir, to wit:
BENEFICIARIES RELATIONSHIP BIRTHDATE
1. ROSARIO MATSUNAGA WIFE OCT. 20, 1964
2. JOSE MATSUNAGA SON MARCH 9, 1984

2. My relationship with persons whose names are listed above are borne by the fact that I
am the lawful spouse and the legitimate/illegitimate father 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 against the law.

AFFIANT SAYETH NAUGHT:

SPO1 DANIEL MATSUNAGA

Affiant

SUBSCRIBED AND SWORN TO before me this _____of __________________

at Calapan City, Oriental Mindoro. Affiant exhibited to me his/her Community Tax Certificate
No._________________ issued at____________________ on_______________.

Doc.No.______ NOTARY PUBLIC

Page No._____
Book No._____
Series of 2018