Republic of the Philippines }

Province of Palawan }s.c.

Municipality of Brooke’s Point }

AFFIDAVIT OF GUARDIANSHIP

I, LUCIA J. BACALLA, of legal age, widow, and a resident of Barangay

Poblacion District I, Brooke’s Point, Province of Palawan, under oath states
that:

1. My late husband ABENDIGO J. BACALLA and I were blessed with

eight (8) children. One of my children is ABENDIGO J. BACALLA, Jr.
was blessed with two (2) children, namely: (1) Kevin Paras Bacalla, and
(2) Vea Paras Bacalla. Since they were born, Kevin and Vea, were
residing with me. At the time they were still little, their father passed
away. A few years later, their mother also left them under my custody;

2. Vea Paras Bacalla, who is now already fifteen (15) years old, is
still under my custody as she is still a minor;

3. On September 26, 2019, Nelrose was admitted at the Southern

Palawan Provincial Hospital in Brooke’s Point, Palawan;

4. I am planning to seek help from Philhealth for the Medical

Expenses incurred by Vea and I was required by the hospital to execute
this affidavit;

5. From the time of that Vea’s father passed away and her mother
left her, I have always maintained and exercised guardianship over her
as she is still a minor; and

6. I am executing this affidavit freely and voluntarily, to attest to the

truth and veracity of the foregoing statements.

IN WITNESS WHEREOF, I have hereunto set my hand this 30 th

day of September 2019 at Brooke’s Point, Palawan.

LUCIA J. BACALLA
Affiant

SUBSCRIBED AND SWORN TO before me this 30 th day of September

2019 at Brooke’s Point, Palawan, affiant exhibited to me her OSCA ID No. 11-
0040 as sufficient proof of her identity.

Doc. No.
Page No.
Book No.
Series of 2019