REPUBLIC OF THE PHILIPPINES)

) SS.
x-----------------------------------------x

AFFIDAVIT OF being single and

LEGAL BENEFICIARIES

, after having been duly sworn to an oath in accordance with law do

hereby depose and state:

1. That I am the eldest in the brood of two of Spouses y;

2. That up to the present I am still living with my parents

who are residents of
3. That I am declaring my parents as my legal beneficiaries
considering that I am still single and have no issue or
child with anybody;

4. That I am executing this affidavit to attest to the truth of

the foregoing statements and in relation to my
application with the Armed Forces of the Philippines;

IN WITNESS WHEREOF, I have hereunto affixed my

signature this 27th day of January, 2015 in the, Nueva Ecija.

Affiant
TIN: 449-531-

SUBSCRIBED AND SWORN to before me this 27 th day of January,

2015 in, Nueva Ecija.