I, [Affiant], Filipino, of legal

age, and a resident of

[Address of Affiant] state under

oath that:

1. I personally know [Name of Person] for a

period of years as his/her [relationship];

2. I also know for a fact that the above person and the person by the name of

"[Other Name of the Same Person] as

appearing in the attached identification documents, refer to one and the same person;

3. As such, I execute this Affidavit to attest to the truth of the above statement and for

whatever lawful purpose it may serve.

I have affixed my signature this_ day of 2022 at-------Philippines.

Affiant

SUBSCRIBED AND SWORN to before me this_ day of 2022, in _

personally appeared [Affiant] exhibiting to me his/her Passport No. issued on

as his/her competent evidence of identity bearing his/her photograph and

signature.

NOTARY PUBLIC

Doc. No._,
Page No._;
Book No._;
Series of

QR-PBAO-AOS / REVISION 0 /APRIL 2015 Philam Life Customer Confidential