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Affidavit Change of Beneficiary

Arleen Din Laurea is requesting to change her GSIS beneficiary from her husband Renrico Laurea Sr. to her two children. She states that she has been married to Renrico for a long time but that he disappeared in March 2018 and is now living with another woman in Pagadian City. Arleen also noticed years ago that Renrico was indifferent towards her and their children, seldom came home, and always found fault with her. As the husband and wife are meant to live together with mutual trust and fidelity, which Renrico has violated, Arleen is revoking him as her GSIS beneficiary and wants to name her children instead.

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Santoy Cartalla
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621 views2 pages

Affidavit Change of Beneficiary

Arleen Din Laurea is requesting to change her GSIS beneficiary from her husband Renrico Laurea Sr. to her two children. She states that she has been married to Renrico for a long time but that he disappeared in March 2018 and is now living with another woman in Pagadian City. Arleen also noticed years ago that Renrico was indifferent towards her and their children, seldom came home, and always found fault with her. As the husband and wife are meant to live together with mutual trust and fidelity, which Renrico has violated, Arleen is revoking him as her GSIS beneficiary and wants to name her children instead.

Uploaded by

Santoy Cartalla
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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Republic of the Philippines. . .

)
Province of Zamboanga Del Sur. . . . )s.s.s
Municipality of Lapuyan
x- - - - - - - - - - - - - - - - - - -x

AFFIDAVIT
(RE: GSIS CHANGE OF BENEFICIARY)

I, ARLEEN DIN LAUREA, 54 years old, Filipino, married, with residence and
postal address at Tipasan, Lapuyan, Zamboanga del Sur, after having sworn to in
accordance to law, we hereby depose and sayeth - THAT:

1. I am a teacher at Department of Education (Dep-Ed – Lapuyan


District), Tipasan Elementary School, Lapuyan, Zamboanga Del Sur;

2. As such I am compulsory member of GSIS as a public school teacher;

3. My beneficiary in such GSIS Retirement and Life Policy is my husband


RENRICO R. LAUREA Sr., 52 years old and a resident of Tipasan,
Lapuyan, Zamboanga Del Sur;

4. We married for a long period of time and blessed with two (2)
Children: Marc Enrico D. Laurea and Enrico D. Laurea Jr., we were
living as family then;

5. However, sometimes on March 2018 he disappeared and did not even


bother to come home anymore until now, because of such actuations
of my husband, I inquired as to his whereabouts and what is he doing,
and there I learned that he was living at Pagadian City with another
woman;

6. I noticed a few years ago that he was very indifferent from us, he
seldom goes home, he did not bother to ask the status of our children
and worst always finds fault of me;

7. The husband and wife should live together, observe mutual trust and
fidelity which my husband has gravely violated;

8. In view thereof, I am now exculpating him as my beneficiary in my


GSIS Life Insurance Policy and benefits and would like to change my
children in lieu of him;

9. I am executing this affidavit to attest to the truthfulness of the


foregoing facts and in support of my application for the revocation of
my husband as the beneficiary and to change the beneficiary of my
GSIS life insurance policy and for whatever legal purposes it may
serve;

IN WITNESS WHEREOF, We hereby affixed our signatures this 15 th day of


October 2018, Lapuyan, Zamboanga Del Sur, Philippines.

ARLEEN DIN LAUREA


Affiant
ID NO.
ISSUED AT:
DATE OF ISSUE:

SUBSCRIBED AND SWORN TO BEFORE ME THIS 15th DAY OF October 2018,


Lapuyan, Zamboanga Del Sur, Philippines, affiants exhibiting proof of identity.

Doc. No. ______; ATTY. JUNSANLY IMBING ITUMAY


Page. No. ______; Notary Public Until December 31, 2018
Book No. ______; PTR NO. 2032772-1/05/2018
Series of 20 _____. IBP No. 017165 -5/18/2017
Roll No. 66713 – 5/23/2017
MCLE: (Admitted to the bar May 23, 2017)

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