REPUBLIC OF THE PHILIPPINES )

CITY OF CALAMBA ) S.S.

AFFIDAVIT OF NOT LIVING

WITH THE PARENTS

I, MARY LYN M. BRILLO, of legal age, Filipino, and with

residence address at B4 L32 Villa Consolacion Subdivision, Brgy.
Looc, Calamba City, Laguna, Philippines, after being sworn to in
accordance with law, do hereby depose and state, that:

1. I am currently employed at iGen Payment Systems

located at Ortigas, Pasig City, as a Backend Software
Developer.

2. Originally, me and my sister Precious Angel M. Brillo

were living with our parents in their residence at B2 L18
Mauro Alcalde Rising Villas, Brgy. Bañadero, Calamba City,
Laguna, Philippines.

3. On 03 October 2021, due to some misunderstanding, me

and my sister decided to move out from our parents and live
independently.

4. At present, me and my sister are currently renting a

residential house at B4 L32 Villa Consolacion Subdivision,
Brgy. Looc, Calamba City, Laguna, Philippines.

5. I am fully and independently supporting all the expenses

for myself and that of my sister, who is also a Person With
Disability (PWD).

6. Since the date that we moved out from our parents’

abode, we no longer communicated with each other up until
present, nor did we receive nor are receiving any kind of
support from them.

7. I am executing this affidavit mainly for the purpose of

availing the benefits of Health Maintenance Organization
(HMO) and to designate my sister as one of my beneficiaries.

1
 8. I hereby execute this Affidavit to attest to the foregoing
facts and for any other purposes incidental to the main
purpose mentioned in the immediately preceding paragraph.

IN WITNESS WHEREOF, I have hereunto affixed my

signature this 11th day of July 2022, in the City of Calamba,
Philippines.

MARY LYN M. ABRILLO

Affiant

SUBSCRIBED AND SWORN to before me this ___ day of July

2022 in ____________________, Philippines, Affiant personally
appearing before me and exhibiting to me her Non-Professional
Driver’s License as her competent evidence of identity, bearing the
License Number D22-19-008024, issued at Calamba City on 18
October 2019, valid until 25 May 2024, and Affiant further avows
under penalty of law to the whole truth of the contents of this
Affidavit.

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