Republic of the Philippines } S.

S Sorsogon

WE, Marivic O. Gabat, of legal age, single, Filipino and presently residing at Poblacion Norte, Barcelona, Sorsogon, and Joy E. Bornel, of legal age, married, Filipino, and permanently residing at Poblacion Norte, Barcelona, Sorosogn, both after having been duly sworn to in accordance with law hereby depose and say: 1. That we personally know Muriel F. Francisco of Poblacion Norte, Barcelona, Sorsogon; 2. That she was born to Pio R. Fulgueras and Maria E. Fulgueras on March 24, 1976 at Barcelona, Sorsogon; 3. That her maiden was Muriel E. Fulgueras; 4. That she was using the said name in all her documents and transactions including her membership in the Social Security System prior to her marriage; 5. That Muriel E. Fulgueras and Jayson B. Francisco contracted marriage on October 8, 2005 at the Iglesia Ni Cristo Chapel, Barcelona, Sorsogon; 6. That as a consequence of marriage she was using Muriel F. Francisco as her name since then; 7. That unfortunately on September 10, 2011 she died at the Bicol Regional Training and Teaching Hospital due to SEPSIS; 8. That with absolute certainty we can attest to the fact that Muriel E. Fulgueras and Muriel F. Francisco are one and the same; 9. That we are not related by consanguinity or affinity to the surviving family of the deceased; 10. That we are executing this affidavit to attest to the veracity of the foregoing facts for whatever legal purpose it may serve. IN WITNESS WHEREOF, WE have hereunto set our hands this 11th day of February, 2013 at Barcelona,Sorsogon.



SUBSCRIBED AND SWORN to before me, at Municipality of Barcelona, Sorsogon, this 11th day of February, 2013 by MARIVIC O. GABATwith CTC No. 27376185 issued at Barcelona, Sorsogon on January 29, 2013 and by JOY E. BORNEL with CTC No. 10148686 at Barcelona, Sorsogon on January 7, 2013 and SSS ID No. 0506071067.


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