REPUBLIC OF THE PHILIPPINES )

Province of Nueva Ecija ) S.S.

Science City of Munoz )

SWORN AFFIDAVIT

I, MR. NESTOR ALCONES PALAGANAS, of legal age, Filipino,

presently residing at Barangay Gabaldon, Science City of Muñoz, Nueva
Ecija and after having been sworn to in accordance with law, hereby depose
and state, THAT:

1. That Late MYNARD QUERDO PALAGANAS was my son.

2. That his date of death was on August 04, 2019 at Barangay

Gabaldon, Science City of Muñoz, Nueva Ecija.

3. I believe that his death was due to accident and no foul play.

4. I decided that the body of my son will no longer undergo an

autopsy for the reason stated above.

5. I have executed this affidavit to attest to the truthfulness of

foregoing facts and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this August 8, 2019 at Science City of Muñoz, Nueva Ecija.

NESTOR A. PALAGANAS
Affiant
SSS NO. 2015349-8

SUBSBRIBED and SWORN to before me this August 8, 2019 at

Science City of Muñoz, Nueva Ecija and I hereby certify that the affiant has
read the contents of his affidavit and understands the same.

Doc. No.: 514;

Page No.: 104;
Book No.: VI;
Series of 2019.