REPUBLIC OF THE PHILIPPINES

CITY OF BACOOR )S.S.

AFFIDAVIT OF ABANDONMENT

I, MARIA CORAZON D. ABUEG, of legal age, Filipino citizen and currently

residing at 121-A Piñahan St. Piñahan Subd. Mabolo 3 City of Bacoor, Cavite,
after having sworn in accordance with law, do hereby depose and STATE:
1. That I am the common law wife of ROBERTO V. SERNANDE SR.;

2. That out of the relationship was born my child named ROBERTO A.

SERNANDE JR.;

3. That my partner Roberto V. Sernande Sr. had abandoned me and my son for
almost twenty seven (27) years and since that time has not communicated
with us nor extended any financial support;

4. Since the abandonment, I have been solely supporting our child;

5. That my son died last September 8, 2020 due to “Acute Myocardial

Infraction”;

6. That I am now claiming his death benefits in Social Security System;

7. That I am executing this Affidavit to attest to the truth of the foregoing facts
and to use the same for purposes of claiming death benefit in Social Security
System.

IN WITNESS WHEREOF, we hereunto set our hands this ________ November

2020 in Bacoor City Philippines.

MARIA CORAZON D. ABUEG

Affiant

Signed in presence of :

______________________ _______________________
 BEFORE ME, a Notary Public for and in the above jurisdiction, this ___ day
of November, 2020 at Bacoor Cavite, personally appeared _______________,
showing her ________________ known to me and to me known to be the same
person who executed and signed the foregoing instrument and who acknowledged
to me that the same is her free voluntary act and deed.
WITNESS MY HAND AND SEAL on the place and date first above
written.

Doc. No. ____; Notary Public

Page No. ____;
Book No. ____;
Series of 2020.