Republic of the Philippines)

Province of Negros Oriental) S.S.

Municipality of Sibulan . . .)

AFFIDAVIT OF HEIRSHIP

I, ROWENA H. PONTILLAS, Filipino, of legal age, widow, and a resident of

Barangay Calabnugan, Sibulan, Negros Oriental, after having been duly sworn to in accordance
with the law, do hereby depose and say that:

I am the surviving wife of the late RITO TORRES FONTILLAS who died sometime on
October 17, 2021, at Calabnugan, Sibulan, Negros Oriental, and was childless;

That RITO TORRES FONTILLAS is a UCT Member;

That I am allowed to receive from any government or private office the UCT/DSWD
claims/benefits of my late husband RITO TORRES FONTILLAS, being his heir;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 17 th day of March

2023, in Sibulan, Negros Oriental, Philippines.

ROWENA H. PONTILLAS
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of March 2023, at Sibulan,
Negros Oriental, Philippines, affiant exhibiting to me her OSCA ID No. 08052 issued on July 25,
2019.

Doc No. 272;

Page No. 56;
Book No. I;
Series of 2023.