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  • Affidavit of Surviving Spouse

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    gille abajar
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    This affidavit is from a surviving spouse of a veteran pensioner who passed away. The surviving spouse declares that since the death of their spouse, they have not remarried, cohabited with another person, or engaged in a common-law relationship. They acknowledge that their survivor pension benefits from the PVAO will terminate if they remarry or enter a common-law relationship. They authorize the PVAO to verify their civil status and agree to reimburse any unduly received benefits after termination of entitlement. The affidavit aims to attest to the truth of the statements in support of continuous receipt of survivor pension benefits.

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    Affidavit of Surviving Spouse

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    This affidavit is from a surviving spouse of a veteran pensioner who passed away. The surviving spouse declares that since the death of their spouse, they have not remarried, cohabited with another person, or engaged in a common-law relationship. They acknowledge that their survivor pension benefits from the PVAO will terminate if they remarry or enter a common-law relationship. They authorize the PVAO to verify their civil status and agree to reimburse any unduly received benefits after termination of entitlement. The affidavit aims to attest to the truth of the statements in support of continuous receipt of survivor pension benefits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    48 views1 page

    Affidavit of Surviving Spouse

    Uploaded by

    gille abajar
    This affidavit is from a surviving spouse of a veteran pensioner who passed away. The surviving spouse declares that since the death of their spouse, they have not remarried, cohabited with another person, or engaged in a common-law relationship. They acknowledge that their survivor pension benefits from the PVAO will terminate if they remarry or enter a common-law relationship. They authorize the PVAO to verify their civil status and agree to reimburse any unduly received benefits after termination of entitlement. The affidavit aims to attest to the truth of the statements in support of continuous receipt of survivor pension benefits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    AFFIDAVIT‌‌OF‌‌SURVIVING‌‌SPOUSE‌ 

    ‌
       ‌
       ‌
    I,‌‌
      ____________________________,‌‌   Filipino,‌‌   of‌‌
      legal‌‌  age,‌‌   widow‌‌  / ‌‌widower,‌‌  with‌‌  address‌‌ at‌  ‌
    __________________________________________‌  ‌and‌  ‌the‌  ‌following‌  ‌contact‌  ‌number‌‌ 
    _______________________,‌‌   after‌‌   having‌‌   sworn‌‌   in‌‌
      accordance‌‌   with‌‌  law,‌‌
      hereby‌‌  depose‌‌ and‌‌ 
    state:‌  ‌
       ‌
    I‌  ‌am‌  ‌a ‌ ‌widow‌  ‌/ ‌ ‌widower‌‌   of‌  ‌__________________________________who‌  ‌was‌  ‌a ‌‌PVAO‌‌  
    pensioner‌‌/‌‌veteran‌‌who‌‌died‌‌on‌‌__________________‌‌at‌‌__________________________;‌  ‌
       ‌
    I‌  ‌hereby‌  ‌declare‌  ‌that,‌  ‌since‌  ‌the‌  ‌death‌  ‌of‌  ‌my‌  ‌spouse‌  ‌(veteran),‌  ‌I ‌ ‌have‌  ‌not‌  ‌remarried,‌‌  
    cohabited‌  ‌with‌  ‌another‌  ‌person,‌  ‌or‌  ‌otherwise‌  ‌engaged‌  ‌in‌  ‌a ‌ ‌common-law‌  ‌relationship.‌  ‌I ‌‌
    acknowledge‌  ‌that‌  ‌my‌  ‌entitlement‌  ‌to‌  ‌survivorship‌  ‌pension‌  ‌from‌  ‌the‌  ‌PVAO‌  ‌will‌‌ 
    automatically‌  ‌and‌  ‌permanently‌  ‌terminate‌  ‌the‌  ‌moment‌  ‌that‌  ‌I ‌‌re-marry,‌‌   co-habit‌‌   with‌‌
      any‌‌
     
    person/engage‌  ‌in‌  ‌a ‌ ‌common-law‌  ‌relationship,‌  ‌whether‌  ‌of‌  ‌the‌  ‌same‌  ‌or‌  ‌opposite‌  ‌sex,‌  ‌or,‌‌  
    whether‌  ‌or‌  ‌not‌  ‌such‌  ‌a ‌ ‌relationship‌  ‌is‌  ‌still‌  ‌subsisting.‌  ‌I ‌ ‌hereby‌  ‌agree‌  ‌unconditionally‌  ‌to‌‌ 
    reimburse/return‌  ‌to‌  ‌the‌  ‌PVAO,‌  ‌without‌  ‌the‌  ‌need‌  ‌of‌  ‌demand‌  ‌or‌  ‌judicial‌  ‌action,‌  ‌all‌‌  
    survivorship‌  ‌benefits‌‌   I ‌‌may‌‌   still‌‌
      unduly‌‌   receive‌‌   after‌‌   my‌‌  entitlement‌‌   thereto‌‌   is‌‌
      terminated‌‌  
    as‌‌stated‌‌above.‌  ‌
       ‌
    Pursuant‌  ‌to‌  ‌and‌  ‌consistent‌  ‌with‌  ‌the‌  ‌declarations‌  ‌I ‌ ‌made‌  ‌above,‌  ‌I ‌ ‌hereby‌  ‌authorize‌  ‌
    the‌  ‌PVAO‌  ‌to‌  ‌secure‌  ‌information‌  ‌regarding‌  ‌my‌  ‌civil‌  ‌status‌  ‌from‌  ‌the‌  ‌Philippine‌‌  
    Statistics‌‌Authority‌‌(PSA)‌ ‌or‌‌other‌‌relevant‌ ‌government‌‌offices‌‌or‌‌even‌ ‌private‌‌entities.‌  ‌
       ‌
    I‌‌
      am‌‌
      executing‌‌   this‌‌
      affidavit‌‌   to‌‌
      attest‌‌  to‌‌
      the‌‌
      truth‌‌   of‌‌
      the‌‌ foregoing‌‌  statements‌‌ in‌‌  support‌‌ of‌‌
     
    my‌  ‌continuous‌  ‌receipt‌  ‌for‌  ‌survivorship‌  ‌pension‌  ‌with‌  ‌the‌  ‌PVAO‌  ‌under‌  ‌Republic‌  ‌Act‌  ‌No.‌  ‌
    6948‌  ‌Sec.‌  ‌11,‌  ‌and‌  ‌for‌  ‌other‌  ‌legal‌  ‌purposes,‌  ‌it‌  ‌may‌  ‌serve.‌  ‌I ‌ ‌fully‌  ‌understand‌  ‌that‌  ‌any‌‌ 
    inaccurate‌‌   and‌‌
      untruthful‌‌   statement‌‌   in‌‌
      this‌‌
      affidavit‌‌   shall‌‌   render‌‌ me‌‌  criminally‌‌  and‌‌ civilly‌‌ 
    liable.‌  ‌
       ‌
       ‌
       ‌
      __________________________________‌  ‌
      ‌Affiant/Name‌‌of‌‌Pensioner‌‌&‌‌Signature‌  ‌
       ‌
      Date:‌ ‌_____________________________‌  ‌
     ‌

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