REPUBLIC OF THE PHILIPPINES )

CITY OF BATANGAS ) S.S.

AFFIDAVIT

I, AILEEN CUETO GUTIERREZ, of legal age, married,

Filipino, and a resident of Sitio Silangan, Brgy. Dumantay,
Batangas City, after having been duly sworn to in accordance
with law, do hereby depose and state:

That I am the daughter of BONIFACIA BAES CUETO

who passed away on January 10, 2022;

That based on her Death Certificate, her immediate

cause of death is UNDETERMINED;

That her true cause of death was due to STROKE;

That I have personal knowledge of her death because I

am present at the time that she passed away;

That I am executing this affidavit to attest to the truth of

all the foregoing facts, and for other legal purposes this may
serve.

IN WITNESS HEREOF, I have hereunto set my hand this

11th day of January 2022 in Batangas City.

AILEEN CUETO GUTIERREZ

Affiant

SUBSCRIBED AND SWORN to before me this 11th day of

January 2022 in Batangas City.