REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.

x ------------------------------------------- x

AFFIDAVIT OF GUARDIANSHIP

I, MARJORIE M. BALITNANG, of legal age, Filipino citizen, widow and presently residing at #100-B
City Camp Alley Extension, Baguio City, Philippines, having been duly sworn to in accordance with law,
do hereby depose and say:

1. That I am the mother of the minor named below who have an interest in the PAG-IBIG provident
benefits of my late husband SHERWIN K. BALITNANG payable by the PAG-IBIG Fund;

NAME OF MINOR DATE OF BIRTH AGE

ALSHANI AQUEEN September 23, 2010 2

2. That I am the guardian of the above-named minor;

3. That the said minor is under my sole care and custody;

4. That I am competent to receive in behalf of the said minor any amounts due her; and

5. That I am not an imbecile, insane, a vagrant or a vicious person or a habitual drunkard or a

habitual criminal, and have not abandoned, neglected or refused to support said minor or caused
her to commit offenses against the law.

IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of November, 2012, at Baguio
City, Philippines.

_______________________
MARJORIE M. BALITNANG
Affiant

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 23rd day of
November 2012, by MARJORIE M. BALITNANG, who has satisfactorily proven her identity to me through
her Tax Identification Number (TIN) 112-333-478 that she is the same person who personally signed the
foregoing affidavit before me and acknowledged that she executed the same.

MARIA PHOENIX M. CHOA

Notary Public
Until December 31, 2014
Unit 3A, 3rd Floor, Porta Vaga Building,
Session Road, Baguio City
(074) 422-3287/ 09276435749
PTR No. 108083; 1-9-12/Baguio City
Roll of Attorney No. 101114; 1-9-12/
Baguio City
IBP Lifetime Membership No. 0821057;
Baguio-Benguet
MCLE No. III-0001178, 07-27-11
Commission Serial No. 75-NC-11 (R)
TIN: 922-596-319

Doc. No. 10;

Page No. 2;
Book No. I;
Series of 2012.