REPUBLIC OF THE PHILIPPINES)

CITY OF PARAÑAQUE )S.S.

AFFIDAVIT OF LEGAL BENEFICIARY

I, IRENE P. LAGARTO, of legal age, single, Filipino, and a resident of
Sitio Malaya, Brgy. Merville, Parañaque City, after having been duly sworn to in
accordance with law hereby depose and say:

1. That I am currently applying for Parañaque Employment Service Office

(PESO) for Livelihood Program;

2. That I am declaring my eldest child, MARY JANE L. PANTOJA as my

legal beneficiary to the above-mentioned program;

3. That I am executing this affidavit as one of the requirements of the said

program I am applying;

4. That I am executing this affidavit to attest to the veracity of the

foregoing for whatever legal purpose that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6 th day of

March, 2022 in Parañaque City, Metro Manila.

IRENE P. LAGARTO
Affiant

SUBSCRIBED AND SWORN, to before me this 6th day of March, 2022 in

Parañaque City, Metro Manila. Affiant exhibited to me her: PhilHealth Card –
01-200098574-9.

Doc. No. __________

Page No. __________
Book No. __________
Series of 2022.