Republic of the Philippines)

Province of Bohol )S.S.

City of Tagbilaran )

AFFIDAVIT OF CONFIRMATION

I, _____________, of legal age, Filipino and a

resident of __________________, a bona fide member of
the Philippine National Police Region VII(PNP-VII),
after having been duly sworn to in accordance with law,
do hereby depose and state that:

1. Pursuant to this affidavit, I am confirming that

the following are my legal beneficiaries and/or heirs,
to wit:

NAME RELATIONSHIP BIRTHDATE

___________________________________________________

2. My relationship with the persons whose names are

listed above are bourne out by the fact that I am the
lawful heirs and legitimate son of the afore-named
persons as evidence by birth certificate.

3. I hold my self criminally and administratively

liable for perjury and dishonesty should any statements
made herein are inaccurate or later on found to be
false and in of law.

AFFIANT SAYTH NAUGHT:

______________________
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of

Febraury, 2020 at Tagbilaran City, Bohol, Philippines.