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GSIS Benefits Waiver Affidavit

The document is a waiver of rights from an heir of a deceased GSIS member. It states that the heir waives all rights and interests to the provident benefits of the deceased from GSIS. It also releases GSIS from any liability regarding the waiver. The heir signed the affidavit to attest to the truth of the waiver.

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8K views1 page

GSIS Benefits Waiver Affidavit

The document is a waiver of rights from an heir of a deceased GSIS member. It states that the heir waives all rights and interests to the provident benefits of the deceased from GSIS. It also releases GSIS from any liability regarding the waiver. The heir signed the affidavit to attest to the truth of the waiver.

Uploaded by

harveypugong
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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WAIVER OF RIGHTS

I, of legal age, single, Filipino citizen, resident of state that:


1. On August 28, 2020, passed away;
2. The deceased was a member of the Government Service Insurance
System (GSIS)
3. I am an heir of the deceased being his son;
4. I hereby waive in favor of all rights and
interest I may have over the provident benefits due the deceased from the
GSIS;
5. I hereby release and discharge the GSIS from any and all liability in
connection with the aforementioned waiver and release of the provident
benefits in favor of the above-named person;
6. I am executing this affidavit to attest to the truth of the foregoing facts
and statements.
I further sayeth not.

Affiant
Witnesses:
___________________ _____________________
Printed Name/Signature Printed Name/Signature

SUBSCRIBED AND SWORN to before me in the


___________________this______day of ________________,by the
affiant, who has satisfactorily proven to me his/her identity through his
identification card as indicated above that he is the same person who
personally signed before me the foregoing Waiver of Rights and
acknowledged that he executed the same.

WITNESS MY HAND AND SEAL.

Doc. No. ______


Page No. ______
Book No. ______
Series of 2020

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