REPUBLIC OF THE PHILIPPINES)

PROVINCE OF NUEVA VIZCAYA)

MUNICIPALITY OF KASIBU)

AFFIDAVIT

I, REBACCA CAFILAS BERNAN, of legal age, Filipino citizen and a

resident of Camamasi, Kasibu, Nueva Vizcaya, after being duly sworn to in
accordance with law hereby depose and say:

1. That I am one of the daughters of our parents Mr. Piter C Bernan

and Maria C. Bernan;(attach is my Certificate of Live Birth)

2. That our parents begot four children namely Lourdes, Martina,

Rebacca and Gerard;

3. That my brother Gerard was employed as a teacher but has

passed away due to accident and has no other beneficiaries;

4. That I am executing this affidavit to attest to the truthfulness and

veracity of the foregoing averments and to prove that I am one of
the siblings of Gerard and to support the claim of the benefit;

IN WITNESS WHEREOF, I have hereunto set my hand this 24 th day of

August 2021 at Kasibu, Nueva Vizcaya.

REBACCA CAFILAS BERNAN

Affiant
DOHR02-2017-3703-00065

SUBSCRIBED AND SWORN TO before me this _________ at

___________, Nueva Vizcaya. The affiant personally appeared before me
presenting her identification card as stated above.

WITNESS MY HAND AND SEAL.

Doc. No.
Page No.
Book No.
Series of 2021