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Republic of The Philippines) City of Pasig) S.S

Felipe P. Bunga-Os filed an affidavit claiming the insurance benefits of his late brother Jerry P. Bunga-Os, who was a policyholder of St. Peter Life Plan with Contract No. N15744179C. Felipe stated that he is the brother and beneficiary of Jerry, and that he is executing the affidavit to attest to the truth of his claim and to receive the insurance payout as the beneficiary. The affidavit was signed on August 6, 2018 in Pasig City.

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286 views1 page

Republic of The Philippines) City of Pasig) S.S

Felipe P. Bunga-Os filed an affidavit claiming the insurance benefits of his late brother Jerry P. Bunga-Os, who was a policyholder of St. Peter Life Plan with Contract No. N15744179C. Felipe stated that he is the brother and beneficiary of Jerry, and that he is executing the affidavit to attest to the truth of his claim and to receive the insurance payout as the beneficiary. The affidavit was signed on August 6, 2018 in Pasig City.

Uploaded by

Rey Baltazar
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)

CITY OF PASIG )S.S.

AFFIDAVIT OF CLAIM

I, FELIPE P. BUNGA-OS, of legal age, widower, Filipino and a resident of


340 Blk. 13 Lot 2 Dilang 1, Nagpayong, Pinagbuhatan, Pasig City,after having been
duly sworn in accordance with law, hereby depose and say:

1. That I am the brother and beneficiary of the late JERRY P. BUNGA-


OS;

2. That my said brother JERRY P. BUNGA-OS, was a St. Peter Life Plan,
holder with Contract No. N15744179C;

3. That as his beneficiary I am claiming his insurance benefit.

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


foregoing allegations and for the purpose of claiming insurance
benefit of my brother.

I N WITNESS WHEREOF, I have hereunto set my hand this 6th day


of August 2018 at Pasig City.

FELIPE P. BUNGA-OS,
Affiant

SUBSCRIBED AND SWORN to before me this 6th day of August 2018, at


Pasig City.

Doc. No.
Page No.
Book No.
Series of 2018.

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