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S
PROVINCE OF ISABELA )
MUNICIPALITY OF ECHAGUE )
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2. That the other surviving legal heirs are my children namely; Rafael L.
Candelaria Jr, 31 years old; Raleth Joy Candelaria-Pinapin, 29 years old, and
Julius Jay L. Candelaria, ____years old, evidenced by their birth certificates
attached to this affidavit as ANNEX “B”;
3. That the said account holds a capital contribution kept by the decedent with
AFPSLAI from ____________ (issued date) up to _____________ (date);
4. That since my children who are both working in Metro Manila and one of
them is a minor, waives their right to claim in favor of the affiant as the one
and only claimant of the termination proceeds of the deceased member;
4. That pursuant to applicable laws, I hereby adjudicate unto myself the above
described membership termination claims by means of this Affidavit and
request that said adjudication be made effective without judicial proceedings
as prescribed by the Rules of Court.
____________________
(Signature of Affiant)
ACKNOWLEDGEMENT