Republic of the Philippines)

Cabanatuan City………….)S.S.
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AFFIDAVIT OF LEGAL BENEFICIARIES

I, JAIME D. LAJOM, JR., of legal age, Filipino and a resident of
Barangay Pinagbayanan, Laur, Nueva Ecija, after having been duly sworn to
in accordance with law, do hereby depose and say, THAT:

1) I am currently applying in the Military Service in the Philippine

Army;

2) As one of my requirements, I am declaring my parents, JAIME D.

LAHOM, SR. and GUILLERMA D. LAHOM as my legal
beneficiaries;

3) I am executing this affidavit to attest the truth of the foregoing and

for whatever legal purpose that it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand

this ___________________ hereat Cabanatuan City.

JAIME D. LAJOM, JR.

Affiant
ID. No. _____________________________

SUBCRIBED AND SWORN TO before me this

________________________ at Cabanatuan City, affiant exhibiting his
competent proof of identity indicated below his name and signature
hereinabove.

Doc No.__________;
Page No. _________;
Book No._________;
Series of 2018