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Republic of the Philippines )

Province of Zambales ) S. S.
Municipality of Iba )

AFFIDAVIT OF
CHANGE OF BENEFICIARY

I, MIGUEL O. BALURAN, of legal age, married, Filipino, and a


resident of Brgy. Pamibian, Candelaria, Zambales, after having been duly
sworn to, in accordance with law, do hereby depose and say:

1.) I am a retired Philippine National Police employee;

2.) I hereby change Lilian Baluran y Hebron as my legal beneficiary in


my records with the PNP and hereby designate my children,
namely:

- Michael H. Baluran; (son)


- Mark Lester H. Baluran; (son)
- Rusell H. Baluran; (son)
- Kenneth H. Baluran; (son)
- Jed H. Baluran; (son) and
- Virginia H. Baluran; (daughter)

My beneficiaries for any benefits that I may receive or get by


reason of my retirement with the Philippine National Police in case
any untoward incident may happen to me.

3.) I am executing this affidavit to attest to the truth of all the foregoing
facts for whatever legal purpose this may serve.

MIGUEL O. BALURAN

SUBSCRIBED AND SWORN to before me this 5 th day of July 2010 at


Iba, Zambales. Affiant exhibited to me his PNP Identification No. 09L280113,
valid until December 28, 2012.

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