Republic of the Philippines)
City of Manila ) … S.S
Affidavit
I, PEMS Calvin Maneja Capuno, a Filipino of legal age, married, resident at no.
540 – A Pavia St., Tondo, Manila, a bona fide member of the Philippine National Police
and presently assigned at Manila Police District, United Nation Ave., Ermita, Manila,
after having been duly sworn in accordance with law hereby depose and say;
1. That, I am married to Melody Simbiling Capuno on September 17, 1995, that
sometime of 2010 we agreed to live separate and apart;
2. That since 2010 my wife has reside and working in Dubai, while I work here in
the Philippines and until this time we have not communicated;
3. That, there is no formal written document which memorializes our separation;
4. That, since we have, in fact, lived separated and apart without interruption;
5. That, in order typically my children are my legal beneficiaries.
6. That, there is no present likelihood of either of us returning to the residence of
the other and there is no reasonable expectation of reconciliation.
I, do solemnly affirm under the penalties of perjury the contents of the foregoing are
true based on our personal knowledge.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of
___________________ in ___________________________.
Calvin M Capuno
Affiant
SUBSCRIBED AND SWORN TO before me this _____ day of _________, 2023 in
________________, Philippines.
Doc. No.______
Page No.______
Book No.______
Series of ______
Republic of the Philippines)
City of Manila ) … S.S
Affidavit
I, PEMS Calvin Maneja Capuno, a Filipino of legal age, married, resident at no.
540 – A Pavia St., Tondo, Manila, a bona fide member of the Philippine National Police
and presently assigned at Manila Police District, United Nation Ave., Ermita, Manila,
after having been duly sworn in accordance with law hereby depose and say;
1. That, I am married to Melody Santos Simbiling on September 17, 1995, that
sometime of 2010 we agreed to live separate and apart;
2. That since 2010 my wife has reside and working in Dubai, while I work here in
the Philippines and until this time we have not communicated;
3. That, there is no formal written document which memorializes our separation;
4. That, since we have, in fact, lived separated and apart without interruption;
5. That, there is no present likelihood of either of us returning to the residence of
the other and there is no reasonable expectation of reconciliation.
I, do solemnly affirm under the penalties of perjury the contents of the foregoing are
true based on our personal knowledge.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of
___________________ in ___________________________.
Calvin M Capuno
Affiant
SUBSCRIBED AND SWORN TO before me this _____ day of _________, 2022 in
________________, Philippines.
Doc. No.______
Page No.______
Book No.______
Republic of the Philippines)
City of Manila ) … S.S
Affidavit of Confirmation
I, PEMS Calvin Maneja Capuno, a Filipino of legal age, married, resident at no. 540 – A
Pavia St., Tondo, Manila, a bona fide member of the Philippine National Police and presently
assigned at Manila Police District, United Nation Ave., Ermita, Manila, after having been duly
sworn in accordance with law hereby depose and say;
1. Pursuant to this affidavit, I am confirming that the following are my legal beneficiaries
and/or heirs, to wit:
NAME RELATIONSHIP BIRTHDATE
Melody Simbiling Capuno Wife July 5, 1975
Maria Calmela Simbiling Capuno Daughter December 1, 1995
Jose Calmelo Simbiling Capuno Son July 25, 1997
Mary Ciara Simbiling Capuno Daughter January 25, 1999
Carlvin Odal Capuno Son November 20, 2011
2. My relationship with persons whose names are listed above are borne out by the fact
that iam the lawful spouse, father of the afore-named children as evidenced by the
attached advisory on marriage; marriage certificate; and birth certificates;
3. That, all the documents I have attached and submitted to the support the updating of my
CDLB are original copies from Philippine Statistics Authority; and
4. I hold myself criminally and administratively liable for perjury and dishonesty should any
statements made herein be inaccurate or later on found to be false and in violation of the
law..
AFFIANT SAYETH NAUGHT:
Calvin M Capuno
Affiant
CP # 0977-338-7674
SUBSCRIBED AND SWORN TO before me this _____ day of _________, 2022 in
________________, Philippines.
Doc. No.______
Page No.______
Book No.______
Series No. _____
