REPUBLIC OF THE PHILIPPINES)

CITY OF ORMOC ) S.S.

JOINT AFFIDAVIT

We, CONCHITA M. BUGTAI and GRACE S. CORAZA both of legal age, Filipinos,
and a residents of Pilar, Cebu, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and say that:

1. We personally know JOSE LARRY A. MATERO a bona fide member at PHILAM

Life Assurance Corp under Policy number 7003109614 and our longtime
neighbor and acquaintance in Pilar, Cebu;

2. That the said JOSE LARRY A. MATERO is now paralyze due to cardiac arrest
sometime on September 2018 and in such he was not able to sign any
documents herein, a copy of Medical Certificate is hereto attached and
made integral part of this affidavit;

3. We further attest to the fact that the as appearing to the Cash Surrender
Form by PHILAM Life Assurance Plan that the thumb mark the same is from
JOSE LARRY A. MATERO;

4. We are not in way related to any of the foregoing person within the fourth
civil degree either by consanguinity or affinity, nor do we have pecuniary
interest in this matter whatsoever;

5. We are executing this affidavit to attest the veracity of the foregoing facts
and for whatever other legal purpose this serves best.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this __ day of

___________ at Ormoc City, Philippines.

CONCHITA M. BUGTAI GRACE S. CORAZA

Affiant Affiant
Valid ID:_________ Valid ID:_____________

SUBSCRIBED AND SWORN TO before me this __ day of _________ at Ormoc City,

Philippines