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REPUBLIC OF THE PHILIPPINES ) S.

S
PROVINCE OF ISABELA )
MUNICIPALITY OF ECHAGUE )
x------------------------------------------x

AFFIDAVIT OF WAIVER OF RIGHTS FROM OTHER LEGAL


CLAIMANTS

I, Rafael Pido Candelaria, 57 years old, married to Leticia Lumbo Candelaria


and now residing at Fugu, Echague, Isabela, Philippines, after having been sworn in
accordance with law, depose and say:

1.That I am the surviving husband of Leticia Lumbo Candelaria who died


intestate at Philippine General Hospital in Manila, Philippines, on January 3,
2019 as evidenced by Death Certificate issued by the Civil Registrar of the
City of Manila with Registry No. 2019-001355 is hereto attached as ANNEX
“A” and made an integral part of this Affidavit;

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”;

2.That said deceased is a member of Armed Forces of the Philippines Savings


and Loans Incorporated (AFPSLAI) – Gamu, Isabela Branch and had a
savings account with account number of ______________ evidenced by her
Passbook No. ________________ hereto attached as ANNEX “C” and made
an integral part of this Affidavit;

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.

IN WITNESS WHEREOF, I have hereunto set my hand this day of 25th


January, 2019, in the Echague, Isabela, Philippines.

____________________
(Signature of Affiant)

Signed in the presence of:

____________________ ______________________ ____________________


Witness Witness Witness

ACKNOWLEDGEMENT