Republic of the Philippines )

______________________ )

AFFIDAVIT OF KINSHIP

I, MAXI CABUHAYAN, of legal age, married, Filipino and presently residing at No.
_________________________________, after having been duly sworn to in accordance with
law, do hereby depose and state that:

1. My grandparents, __________________ and _____________________ (both

deceased) has five children, namely: ALEJANDRA, BARBARA, CARIDAD,
DELAILA and EUGENIA (all deceased).

2. My EUGENIA died without no known heirs except us her nephews and nieces.
Whereas, all the children of my grandparents are dead already.

3. I am the nearest surviving kin and relative of my auntie and grandmother,

____________________________.

4. I am executing this affidavit for the purpose of requesting a copy of my uncle’s and
grandmother’s Death Certificates and all civil registry documents in that regard, with
the Philippine Statistics Authority.

5. FINALLY, I am executing this affidavit to attest to the truthfulness of the foregoing

declarations and for all legal intents and purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 25 th day of June

2021 at _____________________, Philippines.

MAXI CABUHAYAN
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of June 2021 at

________________ Philippines. Affiant exhibited to me his government issued identification
card as competent evidence of his identity.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.