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Cemetery or Burial Expenses 3. Food, Transportation and Other Miscellaneous Expenses During Wake

Vivian D. Doblas incurred 52,000 pesos in funeral expenses for her father Restituto L. Doblas and is waiving her rights to claim the funeral benefits from his SSS membership in favor of her mother, Mary Grace D. Doblas. Vivian paid 27,000 pesos personally for the funeral services, cemetery expenses, and other costs while the coffin costing 25,000 pesos was covered by the city government. Mary Grace confirms that Vivian helped process and pay the funeral costs and is entitled to the SSS claim but is waiving it in her favor. Both Vivian and Mary Grace sign to affirm the details.

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Rose Jean Pernito
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532 views3 pages

Cemetery or Burial Expenses 3. Food, Transportation and Other Miscellaneous Expenses During Wake

Vivian D. Doblas incurred 52,000 pesos in funeral expenses for her father Restituto L. Doblas and is waiving her rights to claim the funeral benefits from his SSS membership in favor of her mother, Mary Grace D. Doblas. Vivian paid 27,000 pesos personally for the funeral services, cemetery expenses, and other costs while the coffin costing 25,000 pesos was covered by the city government. Mary Grace confirms that Vivian helped process and pay the funeral costs and is entitled to the SSS claim but is waiving it in her favor. Both Vivian and Mary Grace sign to affirm the details.

Uploaded by

Rose Jean Pernito
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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WAIVER OF RIGHTS TO CLAIM

To whom it may concern:

I, VIVIAN D. DOBLAS, of legal age, Filipino, single, resident of Purok 6, 72-2


Gempesaw Ext., Poblacion. Brgy. 15-B, Davao City, and is the named payee in the herein
receipt for the expenses that was incurred in the funeral and burial of the deceased SSS
member namely, RESTITUTO L. DOBLAS with SSS No. 0929103389

Expenses Issuing Company Amount in the Receipt


1. Funeral Services Villa-Gan Funeral Homes 2,000.00
2. Cemetery or Burial Expenses Public Wireless Cemetery 17,000.00
3. Food, transportation and 8,000.00
other miscellaneous expenses
during wake
4. Coffin 25,000.00
52,000.00

The Coffin amounting to 25,000.00 was shouldered by City Government


Of Davao-DSWD. The first three expenses, Funeral Services and Cemetery
Expenses & Other Miscellaneous Expenses, with total amount of 27,000.00
was the only expenses paid personally by me, VIVIAN DOBLAS.

hereby waive all my rights and claim in favor of MARY GRACE D. DOBLAS, known to
me as my mother and to be the wife of the deceased member, the full and total amount of the
above-mentioned expenses in connection with the funeral benefits claim that we filed with
the SSS.

That I execute this waiver, freely and voluntarily to attest to the foregoing facts and
statements and for whatever legal purpose this may serve.

________________________________
Signature over Printed Name
January 22, 2021

I, MARY GRACE D. DOBLAS, of legal age, Filipino, and resident of Purok 6, 72-2
Gempesaw Ext., Poblacion. Brgy. 15-B, Davao City and my main contact information is
09518221724, after having been duly sworn to in accordance with law, hereby depose and
say:
That I am the legal spouse of the late RESTITUTO L. DOBLAS who passed away
last December 14, 2020 at our residence.
That upon his death, it was my eldest daughter VIVIAN D. DOBLAS who
shouldered and help me process the funeral expenses, from his wake down to his burial.
That the above-named deceased was a member/retiree of the Social Security System
during his lifetime; and as such, one of its benefits is the funeral/burial claim;
That being the one who paid for the expenses mentioned below, my eldest daughter
VIVIAN D. DOBLAS, is entitled for the said claim;
Expenses Issuing Company Amount in the Receipt
1. Funeral Services Villa-Gan Funeral Homes 2,000.00
2. Cemetery or Burial Expenses Public Wireless Cemetery 17,000.00
3. Food, transportation and 8,000.00
other miscellaneous expenses
during wake
4. Coffin 25,000.00
52,000.00

That for reasons of gratuity and generosity, my eldest daughter waive all her rights
and interest to claim the Funeral/Burial Benefits of the afore-mentioned deceased with the
SSS in favor to me, MARY GRACE D. DOBLAS.
Writing this letter to confirm the said details above and it may serve whatever
purposes in terms for funeral benefit filed.

__________________________________
Signature over Printed Name of Claimant

__________________________________
Signature over Printed Name of Eldest Daughter

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