Republic of the Philippines)

City of General Trias, Cavite) S.S.

AFFIDAVIT OF GUARDIANSHIP

I, Arnel Butlig Domalaon, of legal age, single/married/widow, Filipino citizen,

and presently residing at B24 L88 Cluster 4 Bella Vista Subd., Brgy
Santiago, General Trias City, Cavite, after having been duly sworn to in
accordance with law, do hereby depose and say:

1. That I am the uncle and guardian of the following minor/s who has
/have an interest in the St. Peter Special Program for CAB Assistance
Benefit /ECAB/ Insurance Claim of the late Editha B. Domalaon
payable by St. Peter Life Plan Inc.

Full Name of Minor/s Date of Birth                   Age

Karl Ehdzxel Domalaon 10/8/2010 11

Princess Kylie Domalaon  09/19/2011 10

Kim Zhailyn D. Lacson      02/25/2019 3

2. That the above-mentioned minor/s is/are under my care and custody; 

3. That I am competent to receive in behalf of the said minor/s any amount/s due
him/them; and 
4. 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/s or caused
him/them to commit offenses against the law. 
5. That I am executing this affidavit to attest to the truth of all the foregoing
statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _______
2022 at ______________, Philippines.

                                                                                    ARNEL B.
DOMALAON
                                                                                                Affiant
                                

            SUBSCRIBED AND SWORN to before me this ____ day of ______, 2022

in _________, Philippines, affiant exhibiting to me his/her competent evidence
of identity by way of _______________ issued at ___________ on ________________.

NOTARY PUBLIC                            
Doc No.:  _____                                                             
Page No.: ______                                           
Book No.: ______                                              
Series of 2022