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Republic of the Philippines )

City of ______ ) S.S.
x--------------------------x

AFFIDAVIT OF GUARDIANSHIP

I, MIKE MARTIN DEE. TAN , of legal age, single/married/widow,

Filipino citizen, and presently residing at POBLACION TACURONG CITY
SULTAN KUDARAT, after having been duly sworn to in accordance with
law, do hereby depose and say:

1. That I am the ___(state relationship)__ and guardian of the following

minor/s who has / have an interest in the _______________ of the late
_________________________ payable by ________________;

Full Name of Minor/s Date of Birth Age

ELVERO TAN UY 02/02/ 2013 10
_______________ _________ ______
_______________ _________ ______

2. That the above mentioned minor/s is/are under my care and custody;

3. That I am competent to receive in behalf of the said minor/s any

amount/is due him/them; and

4. That I am not an imbecile, insane, a vagrant or a vicious person or a

habitual drunkard or a habitual criminal, and have not abandoned,
neglected or refused to support said minor/s or caused him/them to
commit offenses against the law.

5. That I am executing this affidavit to attest to the truth of all the

foregoing statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 5th day of

November 2023 at Tacurong City, Philippines.

________________
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Affiant

SUBSCRIBED AND SWORN to before me this 5th day of

November 2023 in Tacurong City, Sultan Kudarat, Philippines, affiant
exhibiting to me his/her competent evidence of identity by way of driver's
license issued at Tacurong City on January 04, 2023.

Doc No. : _____

Page No.: ______
Book No.: ______
Series of 2014 Notary Public