REPUBLIC OF THE 

PHILIPPINES )
Province/City__________________  ) SS.

AFFIDAVIT OF CHANGE OF BENEFICIARY

I, ABIATHAR D.R. MIZONA, of legal age and residing/with address

at Blk 11 Lot 16, AGL Heights, Brgy. Caalibangbangan, Cabanatuan City,
N.E.,  under oath, state:

1. That, I am a member of the following Mortuary Associations;

a. MAGANDANG BUHAY NG HARANISTA NG

NUEVA EJICA AT KARATIG, INC. with the
ID/Member No. 00515;

b. HAWAK-KAMAY NA MGA HARANISTA NG

LLANERA AT KARATIG with the ID/Member No.
4247.

2. That my current beneficiaries for the following Mortuary

Associations are;

a. Isachar D.R. Mizona - MAGANDANG BUHAY NG

HARANISTA NG NUEVA EJICA AT KARATIG, INC.;
b. Joselyn M. Mizona - HAWAK-KAMAY NA MGA
HARANISTA NG LLANERA AT KARATIG, INC.

3. That, I am now assigning CHRISTINE JOY M. AVILA as my new

beneficiary replacing Isachar D.R. Mizona and Joselyn M. Mizona.

4. That, I am executing this Affidavit to attest to the truth of the

foregoing facts and to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this ___

day of _______________, 2020  at __________________________.

ABIATHAR D.R. MIZONA

Affiant

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 SUBSCRIBED AND SWORN to before me this ___ day of
_______________ , 2020 at _______________________________,
Affiant exhibiting to me his __________________ bearing No.
________________ issued at _____________________________ on
___________________________.

NOTARY PUBLIC

Doc No. ________;

Page No. _______ ;
Book No. _______;
Series of 202__.

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