December 23, 2021

PHILIPPINE STATISTICS AUTHORITY

Trece Martires City
CALABARZON Region IV-A

Dear Sir/Madam:

Greetings!

I write to request for the Death Certificate of my common-law-spouse,

_______, who died last November 25, 2021.

We had lived together as live-in partner for eleven (11) years and bore two
(2) children out of wedlock, both recognized by their father and using his lastname,
Arellano.

I filed for registration of his death with the Civil Registry of Silang and
obtained a copy of his Death Certificate. However, his legal wife took it from me
under the threat of legal actions.

I am requesting for the said Death Certificate for the purpose of the following:

1. funeral claims from SSS

2. claims of SSS benefits of minor children

I wish my children to receive any claims from Social Security Services due to
them as their father’s beneficiaries in accordance to law as well as to pay for the
balance I owe to the funeral homes that provided the funeral services. I exerted all
necessary effort to obtain authorization to file for request for the said Death
Certificate but it all turned futile.
 Attached here are the Certication of Cohabitation issued by Brgy. Anahaw-
1, Silang, Cavite where we reside as well as the copies of Certificates of Live Birth
of my children issued by PSA bearing their farther’s name: _______. and _______.

I am praying for your favorable action on my request.

Thank you and more power.

Sincerely yours,