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Affidavit On Facts of Death: Atty. Aldrin P. Alimbuyog

Myrna D. Untalan affirms in an affidavit that her husband Edgardo M. Untalan passed away on April 19, 2020 between 4-5pm at their home in Brgy. Masiit, Calauan, Laguna from chronic kidney disease at the age of 58. She was his wife and caregiver, and registered his death with the local civil registrar. She executed this affidavit to attest to the details of his death for legal purposes. The affidavit was sworn before a notary public in Calauan, Laguna on June 5, 2020.

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3K views1 page

Affidavit On Facts of Death: Atty. Aldrin P. Alimbuyog

Myrna D. Untalan affirms in an affidavit that her husband Edgardo M. Untalan passed away on April 19, 2020 between 4-5pm at their home in Brgy. Masiit, Calauan, Laguna from chronic kidney disease at the age of 58. She was his wife and caregiver, and registered his death with the local civil registrar. She executed this affidavit to attest to the details of his death for legal purposes. The affidavit was sworn before a notary public in Calauan, Laguna on June 5, 2020.

Uploaded by

Rich Razon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LAGUNA)
Municipality of Calauan )S. S.

AFFIDAVIT ON FACTS OF DEATH


(regarding the place, date, and time of death)

I, MYRNA D. UNTALAN, of legal age, Filipino citizen, resident of and with postal
address at Brgy. Masiit, Calauan, Laguna, under oath, depose and state,

1. That I am the legitimate wife and immediate relative of the deceased EDGARDO
M. UNTALAN, who died on April 19, 2020 at his residence address located at 373 Brgy.
Masiit, Calauan Laguna and the fact of his death was duly registered at the Local Civil Registrar
of Calauan, Laguna;

2. That being the wife if the late EDGARDO M. UNTALAN, I know that the time
of his death was between 4:00 o’clock in the afternoon to 5:00 o’clock in the afternoon at the age
of 58 because we live in the same house at the time of his death and that I am also the one who
attended to his medical needs;

3. That I also know the fact that the cause of his death was chronic kidney disease;

4. That I am executing this affidavit in order to attest to the truthfulness of the


foregoing facts and circumstances and in order to inform proper authorities and/or persons
concerned in connection with the place, date, and time of death of the late EDGARDO M.
UNTALAN, and for whatever legal intent and purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th day of June


2020 at Calauan, Laguna.

MYRNA D. UNTALAN

SUBSCRIBED AND SWORN to before me a Notary Public for the Municipality of Calauan,
Bay, Los Banos and in the City of Calamba Laguna with office address at 2/F, Villaran Building,
Alvela St., Brgy. Kanluran Calauan Laguna, this 5th day of June 2020 personally appeared the
above named affiant showing to me his Voter’s ID No. 34060055BA2362MDU20000 and avows
under penalty of law to the whole truth of the contents thereof.

ATTY. ALDRIN P. ALIMBUYOG


NOTARY PUBLIC
2F, Villaran Building, Alvela St.
Brgy. Kanluran, Calauan, Laguna
Roll. No. 73376
Doc. No.: 389;
IBP. 113017/LAGUNA
Page No.: 81; PTR No. 8003490 /01-02-20 / Calauan, Laguna
Book No.: 4; MCLE: Newly admitted to the BAR
Series of 2020. Email Address; aldrinalimbuyog1@gmail.com
Cellular Phone No. 09171902738

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