Republic of the Philippines)

Province of Cebu------------)
City of _______________)

AFFIDAVIT OF KINSHIP

I, ___________________, Filipino, widow, of legal age, a resident of Barangay

________________________, Cebu, after having been duly sworn to in accordance with
law, do hereby depose and state:

1. That my husband namely, _____________________, was a police retired and a

former member of the Philippine National Police (PNP). Being such, he had
opened a Premium Savings Account at PUBLIC SAFETY SAVINGS AND
LOAN ASSOCIATION, INC. (PSSLAI) whose business address is now
located at ___________________, Cebu City;

2. That on _______________, my husband died in our residence in Barangay

Poblacion, Aloguinsan, by natural death. As his lawful, true, and legal wife, I
am now presently in the process of complying the requirements for the release
of proceeds or savings he had left at PSSLAI;

3. That one of the requirement that I need to submit at said financial institution is
an affidavit of kinship declaring that I am the legitimate wife of
______________________;

4. That I am expressly declaring that I and _________________________ were

lawfully and legally married on May 17, 1980 at the Muncipality of
__________________, Cebu. Hence, being her surviving spouse, and directly
related or next kin to him, I am duly entitled to receive any claim or benefit
whatsoever in conjunction to the death of my husband;

5. That I am executing this affidavit to attest the veracity of the foregoing

statements.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of

_______________ 2023 at __________________, Cebu, Philippines.

.
___________________
Affiant

SUBSCRIBED AND SWORN to before me this ______ day of

________________ 2023, at __________________, Cebu, Philippines.