Republic of the Philippines)

Quezon City) S.S.

AFFIDAVIT OF NEAREST KIN AND AUTHORIZATION

KNOW ALL MEN BY THESE PRESENTS:

I, _ _ of legal age, Filipino, widowed, and a resident of ____________, Quezon City,

Metro Manila, after having been sworn in accordance with law, hereby deposes and
states the following:

1. That I am the sister of the deceased (“deceased sister”) who died on

______ in ______;

2. That at the time of my deceased sister’s death, she was only

survived by her siblings since at the time of her demise, our parents
already expired and she left without having a legal spouse and
children;

3. That the deceased sister was only survived by her legitimate

siblings, including the herein affiant who was the duly authorized
representative among the surviving heirs;

4. That my deceased sister has several legal documentation

requirements and would need a Certificate of No Marriage
(“CENOMAR”) from the Philippine Statistics Authority (PSA) in order
to process such documentations;

5. Being one of the surviving siblings duly authorized by all of the

surviving heirs, I hereby declare under oath my relationship to the
deceased sister.

6. By virtue of my relationship with the deceased sister, I am rightfully

authorized to apply, request, process and receive the CENOMAR
from the PSA; and

7. That I am executing this Affidavit of Nearest Kin and Authorization to

attest to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 17th day of February
2021 in the City of Quezon City, Metro Manila, Philippines.

_________________________ _
Name and Signature of Affiant

SUBSCRIBED AND SWORN to before me this _17th_ day of FEBRUARY 2021_,

Affiant exhibiting her Senior Citizen I.D. No. ____ issued by _the Quezon City
Government, Philippines.

__________________________
Public Attorney II
(Pursuant to R.A. 9406)