REPUBLIC OF THE PHILIPPINES)

PROVINCE OF KALINGA )
TABUK CITY ) S.S. 
                                                     
AFFIDAVIT OF LEGAL BENEFICIARY

I, MAGWAY B. PULLIS, Filipino, of legal age, widowed, residing at Bugnay, Tinglayan,

Kalinga, after having been sworn to in accordance with law hereby depose and state:
 
1. That I am the beneficiary of my deceased spouse Bong Bagsao Pullis, who
was a member in the Armed Forces of the Philippines;

2. That I'm the closest surviving relative or the Decedent, or the duly
appointed fiduciary of the estate of the Decedent;

3. That I have a legal claim to all pensions and benefits of my deceased

husband; and,

3. That I am executing this affidavit to attest to the truth of the foregoing and
for whatever legal purposes it may serve.

 
IN WITNESS WHEREOF, I have hereunto set my hand this 16th day of June at
Tabuk City.
 
                  
MAGWAY B. PULLIS
PhilHealth No. 04-224017822-7
Affiant

 
          SUBSCRIBED AND SWORN to before me, this 16th day of June, 2021 in Tabuk
City, Kalinga by the affiant exhibiting to me her PhilHealth identification card as shown
above.

 
 
 
Doc.  No. :  ________;
Page  No. :  ________;
Book No. :  ________;
Series of 2021.