Republic of the Philippines)

Davao City ) S.S

x--------------------------x

AFFIDAVIT
I, Armando S. Torrefiel, Filipino, married but separated de
facto, of legal age, and a resident of Busaon, Tagum City after
having been duly sworn to in accordance with law hereby depose
and say:
1. That I am a bonafide member of Social Security System
(SSS);

2. That my wife Norina Bantayan- Torrefiel is designated

as one of my primary SSS beneficiaries;

3. That I have been separated in fact from my wife since

2017 when she abandoned me and our children and
consequently cohabited with another man;

4. That though there is no judicial process of annulment

or legal separation, my estranged wife has not been
living with me and has not been dependent on me for
support for almost five (5) years;

5. That any benefits owing to me as a member upon my

death should go to my legitimate children Lara Mae B.
Torrefiel and Norman B. Torrefiel; and

6. That I execute this affidavit to attest to the truth

of the foregoing facts, to inform SSS that my
estranged wife Norina Bantayan- Torrefiel is not my
dependent and beneficiary and for the purpose of
declaring my children as my beneficiaries.

IN WITNESS WHEREOF, I have hereunto set my hand this

_____________at Davao City, Philippines.

Armando S. Torrefiel
Affiant

SUBSCRIBED AND SWORN to before me this _______________ at

Davao City, Philippines affiant exhibiting to me his
____________________ as competent evidence of his identity.

Doc. No._____;
Page No._____;
Book No._____;
Series of 2022.