Republic of the Philippines)

Cagayan de Oro City )Sc.

AFFIDAVIT
Re: WAIVER OF AUTOPSY

I, ______________of legal age, Filipino, single and a resident of ______________, after

having been duly sworn to in accordance with law, do hereby depose and state:

1. That I am the brother of the late __________ who died only this early morning of
______________, due to an apparent vehicular accident;

2. That upon consultation with my parents, and we decided as a family being the legal
next-of-kin, waive our right for a medical postmortem examination (autopsy) on the remains of the
above-named decedent as it is apparent that the said vehicular accident cause his untimely death;

3. That we fully understand that in not performing such an autopsy, the PNP or NBI may
not be able to establish the definite cause of his death, which may affect the outcome of possible
legal proceedings as well as any claims, if applicable;

4. That I and all his heirs, including our parents, shall not hold the PNP, NBI or any
government agencies for any loss and injury that may arise from the non-performance of such
autopsy;

5. That I am executing this affidavit to attest the veracity of the foregoing statements and
for whatever legal purposes this Affidavit may serve.

IN WITNESS WHEREOF, I hereunto affixed my signature this December 4, 2020, in

Cagayan de Oro City.

ROBERTO A. SETIER, JR.

Affiant

SUBSCRIBED AND SWORN to before me this December 4, 2020, in Cagayan de Oro City.