Republic of the Philippines }

Province of Pangasinan } s.s.

Municipality of Villasis }

AFFIDAVIT OF GUARDIANSHIP

I, LEONORA LUZON y PANDELA, of legal age, married and resident of

Brgy. Lipay, Villasis, Pangasinan, after having been sworn to in accordance with
law, do hereby depose and say:

1. That I am the aunt and guardian de facto of JESHARY BLAIRE V.

PANDELA, 17 years old;

2. That both her father is dead and we lost contact to her mother since 2012;

3. That her father “GERONIMO M. PANDELA” died on September 8, 2021

was my brother;

4. That since then, she was already living with me;

5. That I am the nearest kin of said child to be entrusted of her custody, and I
have assumed parental responsibilities over her until the present time.
Such parental responsibilities include custody and care;

6. I am executing this affidavit to attest to the truthfulness of the foregoing

statements and for all the legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 27 th day of

December 2023 at Villasis, Pangasinan.

LEONORA LUZON y PANDELA

Affiant
National ID No. 4921-7294-1842-5475

SUBSCRIBED and sworn to before me on the date and place above

written. Affiant personally appeared and declared that she voluntarily executed,
read and understood her statement to be true based on her personal knowledge.

kmab