REPUBLIC OF THE PHILIPPINES]

SORSOGON CITY ] S. S.

AFFIDAVIT OF WAIVER
We, SAMUEL D. DEDUQUE, ANNIE D. DONES, GASPAR D. DONES,
ELMER D. DONES JR. MERIAM D. DENIEGA, ANNA MARIE D. DONES and
MA. JOSIE D. EBIO, the surviving children of the late ELMER D. DONES Sr., all of
legal age, Filipinos with residence and postal address at Bacon District Sorsogon
City, under oath depose and state:

1) That we are the surviving children of the late Elmer D. Dones who died at
his residence in Sitio Banao, Barangay Salvacion, Bacon District Sorsogon
City;

2) That the cause of his death was unknown to us since his body was
discovered last March 9, 2021 in his residence by a neighbor in Barangay
Salvacion Bacon District Sorsogon City;

3) That when his body was found it was already decomposing and it was
advised by the staff of the funeral service parlor that the body must be
buried immediately, his body was buried in the afternoon of March 9, 2021
at around 4:00 in afternoon;

4) That the Police Officer who arrived to investigate on the circumstances of

the death of our father concluded that there is no evidence or indication of
any foul play;

5) That we are executing this affidavit to attest to the truth of the foregoing
statement and we are WAIVING our rights to conduct autopsy or
postmortem examination for the purpose of determining the cause of the
death of our father;

IN WITNESS WHEREOF we have hereunto set our hand this ____ day of
March 2021 at Sorsogon City, Philippines.

AFFIANTS:

SAMUEL D. DEDUQUE MERIAM D. DENIEGA

ANNIE D. DONES ANNA MARIE D. DONES

GASPAR D. DONES MA. JOSIE D. EBIO

ELMER D. DONES JR.

 SUBSCRIBED AND SWORN to before me this _____ day of March 2021,
at Sorsogon City, affiants personally appeared before me and exhibited their
Government issued Identification Cards.

Notary Public

Doc No. _____

Page No. _____
Book No. _____
Series of 2021