Professional Documents
Culture Documents
3A
City of Cebu……………………………….) S.S.
X------------------------------------------/
That I am the widow of the late CARMELO S. TAMAYO, who died at Adventist Hospital
Cebu, 400 Tres De Abril St., Cebu City on August 29, 2016.
That the names and pertinent data of the aforementioned deceased member’s
immediate relatives and next to kin are as follows:
COMMON-LAW
DATE OF UNION ADDRESS
HUSBAND/WIFE
none n/a n/a
SUBSCRIBED AND SWORN to before me this 23rd day of September 2016 at Cebu City,
Philippines, affiant who is personally known to me and exhibiting to me the following:
Competent Evidence of Identity
Affiant
Type of ID ID Number and Expiry Date (if applicable)
JOSEFINA C. TAMAYO 1 SSS 06-0289149-7