AFFIDAVIT OF GUARDIANSHIP

Republic of the Philippines )

Municipality of General Tinio ) S.S.
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I, Virginia Gonzales Atang, of legal age, single, residing at Gulod Street, San Pedro
General Tinio Nueva Ecija, after being sworn to in accordance with law, depose and say:

1. That I am the biological mother of the minor Benedicto Beltran Y Atang who has an
interest in the proceeds of the death aid benefit from GSIS and PAG-IBIG of the late
Benedicto V. Atang;

2. That Benedicto V. Atang died on 11 November 2020;

3. That the above mentioned minor is under my custody;

4. That I am competent to receive on behalf of the said minor the amount due him in the
proceeds of the death aid benefit of the deceased;

5. That I am not a vagrant or vicious person or a habitual drunkard or a criminal and has
not abandoned, neglected or refused to support said minor or caused him to commit
offenses against the law;

6. That the said minor does not own any real property;

7. That I am executing this affidavit to attest to the truth of the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of December ,
2020 in the Municipality of General Tinio, Nueva Ecija Philippines.

Virginia Gonzales Atang

Affiant
VIN: 4910-0031A-G2375VGA2000

SUBSCRIBED AND SWORN TO before me, this 15th day of December, in the
Municipality of General Tinio by Virginia Gonzales Atang.

Atty. Elijah B. Bactol

Doc. No. Notary Public
Page No. Commission Serial No. 07-20
Book No. I Until December 31, 2022
Series of 2020 Roll of Attorney 74375
IBP No. 125449 7July2020
PTR No. 6481672 30July2020, Peñaranda N.E.