Republic of the Philippines…...

)
Province of Leyte………………….)

Municipality of Santa Fe…)s.s.

AFFIDAVIT OF CONFIRMATION
I, Rolando Carit Arribe Jr., a Filipino of legal age, a resident of Barangay Bulod Sta. Fe,
Leyte, after having been duly sworn to in accordance with law, do hereby depose and says that:

1. Pursuant of this affidavit, I am confirming that the following are my legal beneficiaries
and/ heirs, to wit:
NAME RELATIONSHIP BIRTHDAY
(mm/dd/yyyy)
EVELYN C. ARRIBE MOTHER 01/28/1968
ROLANDO C. ARRIBE SR. FATHER 08/12/1971

2. My relationship with persons whose names is listed above are borne out by the fact that
I am the lawful Son of the afore-named persons as evidence by the attached birth
certificates; and
3. I hold myself criminally and administratively for perjury and dishonesty should any
statements made herein are inaccurate or later or found to be false and in violation of
law.
AFFIANT SAYETH NOTE:

Rolando C. Arribe Jr.

Affiant

Contact No. 09367761490

SUBSCRIBE AND SWORN to before me this __________ day of ___________________________

at________________________________ Philippines.

Doc. No. ____________

Page No. ____________

Book No. ____________

Series No. ___________