REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SORSOGON ) Sc.

SORSOGON CITY )

AFFIDAVIT OF GUARDIANSHIP

I, SALVACION G. MIRANDA, of legal age, Filipino, single and a

resident of J. Reyes Street, Barangay Talisay, Sorsogon City after having
been sworn to in accordance with law do hereby depose and state:

1. That I am the biological mother and presently the guardian of

IRADHEN M. JIMENEZ, 14 years old, GABRIEL ANGELO M.
JIMENEZ, 11 years old, and AUBREY SOPHIA M. JIMENEZ, 5
years old;

2. That the biological father of the foregoing children is JOSE

MANUEL V. JIMENEZ who died on August 15, 2020. During the
lifetime of MANUEL, he acknowledged and reared said children;

3. That with his demise, the children were left solely under my care
and custody;

4. That I am now processing the claim for survivorship benefit of

MANUEL before the Government Service Insurance System;

5. That I am executing this affidavit in order to attest to the veracity

of the foregoing statements and to affirm that the same are true and
correct to the best of my knowledge and belief, more particularly
to facilitate the processing of my survivorship benefit claim of
the late Manuel V. Jimenez before the GSIS, and for all legal
intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 28th

day of October, 2020 at Sorsogon City.

SALVACION G. MIRANDA
Affiant

SUBSCRIBED AND SWORN to before me this 28th day of October,

2020 at Sorsogon City.