REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BATANGAS ) S.S.

MUNICIPALITY OF BALAYAN )

AFFIDAVIT OF LOAN DENIAL

I, WILFREDO C. DELA CRUZ, 61 years old, married, Filipino and

a resident of Brgy. District 10, Balayan, Batangas, after having been duly
sworn to in accordance with law hereby deposes and states that:

1. I retired from the Bureau of Fire Protection on December 28, 2012

with a rank of Senior Fire Officer I;

2. Sometime in November 2017, I processed and submitted all necessary

documents to Government Service Insurance System - Batangas
Branch office for my benefit claims on GSIS Life Insurance;

3. On January 9, 2018 I received a letter from Celeste E. Ferreras,

Branch Manager of GSIS Batangas Branch office, dated January 3,
2018, informing that my claims have been denied due to outstanding
policy loan amounting to Php 3,160.06, outstanding salary loan
amounting to Php 110,977.70 and outstanding emergency loan
amounting to Php 25,541.59. A copy of the letter from GSIS Batangas
Branch dated January 3, 2018 is attached herewith as Annex “A”

4. I hereby unequivocally deny having contracted the abovementioned

loans;

5. I also went to the Bureau of Fire Protection – Personnel Division in

order to inquire about the alleged loans. According to their records I
have not contracted the abovementioned loans;

6. I am executing this Affidavit to attest to the foregoing facts to deny

absolutely and entirely having contracted the abovementioned loans
and for all legal intents and purposes.

IN WITNESS WHEREOF, I hereby affixed my signature this 19th

day of February, 2018 in Balayan, Batangas.

WILFREDO C. DELA CRUZ

Affiant
 SUBSCRIBED AND SWORN TO before me this 19th day of
February 2018 in Balayan, Batangas, affiant exhibiting to me his Bureau of
Fire Protection (Retired) Identification Card issued at Quezon City,
Philippines on February 13, 2018.

ATTY. BRYAN ALPHONSO E. PEREZ

Public Attorney II
Pursuant to R.A. 9406