AFFIDAVIT OF DEATH BY NEAREST KIN

I, ERIC REY R. BONIFACIO, Filipino, of legal age, married and

resident of Brgy. 83-B, San Jose, Tacloban City, Leyte, Philippines, after
having been duly sworn in accordance with law, hereby depose and state
that:

1. I am one of the children of the late BALBINA RUIZ BONIFACIO, who

died on December 10, 2022, at her residence in San Gerard Heights
Subdivision, Tacloban City.

2. I am one of the closest surviving heirs of Balbina Ruiz Bonifacio.

3. I am executing this affidavit for the purpose of the late registration of

the Death Certificate of my late mother from the Philippine Statistics
Authority (PSA), Office of the Civil Registry and to declare the truth of
the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 02

February 2023 at Tacloban City, Philippines.

ERIC REY R. BONIFACIO

Affiant

SUBSCRIBED AND SWORN TO before me, this 02 February 2023

in Tacloban City, Philippines, affiant being personally known to me.
 

Doc. No.:____;
Page No.:____;
Book No.:____;
Series of 2023.