REPUBLIC OF THE PHILIPPINES )

___________ CITY_________________) S.S.

AFFIDAVIT OF LEGAL HEIRS

WITH WAIVER OF RIGHTS

We, _______________________________________________________ of legal

age, Filipino, and with residence address at
___________________________________________________ City, state under oath
that:

1) We, are the only surviving son / daughter of the late

____________________________________, who passed away on
__________________________________________ at _______________ City;

2) Said deceased died without leaving any Will or Debts in favor of any person or
entity;

3) The deceased left a CAPITAL CONTRIBUTION / SAVINGS DIVIDEND

account/claim in the Air Materiel Wing Savings and Loan Association, Inc.
(AMWSLAI) under Account No.
_____________________________________________________;

4) That for love and affection we hereby WAIVE / CEDE / TRANSFER all our
rights and interest on the CAPITAL CONTRIBUTION/SAVINGS DIVIDEND
ACCOUNT/CLAIM all in favor of _______________________;

5) We hereby undertake and assume the responsibility in case anybody would claim
the said CAPITAL CONTRIBUTION/SAVINGS DIVIDEND; and,

6) We hereby relieve AMWSLAI, its Officers and Employees from any

administrative and or civil liabilities that may incur upon the release of such
claim/benefit/account.

Signed this ____ day of ___________________________,

2018__________ City.

___________________ ____________________ ___________________

Affiant Affiant Affiant

With my Acceptance

____________________
 ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )

______________ CITY ) S.S.

BEFORE ME, the undersigned Notary Public for and in _____ City this ___ day
of _____________________ 2018, personally appeared:

Name: Signature Type/ID No.

1.___________________ _____________________ _______________________

2.___________________ _____________________ _______________________
3.___________________ _____________________ _______________________
4.___________________ _____________________ _______________________

known to me and to me known to be the same person who executed the foregoing
instrument and acknowledged to me that the same his/her free and voluntary act and
deed.

The foregoing instrument consists of two (2) pages including this page on which
the acknowledgment is written, signed on the left hand margin of each and every page
thereof by the party and her instrument witnesses.

WITNESS MY HAND AND SEAL on the day and place hereinabove

mentioned.

NOTARY PUBLIC
Doc No. _____
Book No._____
Page No._____
Series of 2018