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Affidavit of Guardianship

This document is an Affidavit of Guardianship stating that the affiant is the guardian of a minor born on October 29, 2013, who is entitled to insurance proceeds from the affiant's deceased sister. The affiant confirms they are the sole guardian, capable of receiving the insurance proceeds, and affirms their sound character. The affidavit is executed to support an insurance claim with St. Peter Life Plan, Inc.

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Neil Adonis Usaraga
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53 views1 page

Affidavit of Guardianship

This document is an Affidavit of Guardianship stating that the affiant is the guardian of a minor born on October 29, 2013, who is entitled to insurance proceeds from the affiant's deceased sister. The affiant confirms they are the sole guardian, capable of receiving the insurance proceeds, and affirms their sound character. The affidavit is executed to support an insurance claim with St. Peter Life Plan, Inc.

Uploaded by

Neil Adonis Usaraga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

CITY OF TAGBILARAN )S.S.

AFFIDAVIT OF GUARDIANSHIP

I, , of legal age, Filipino, married and a resident of , Bohol, Philippines,


after having been duly sworn to in accordance with law, depose and say:

1. That I am the guardian of who was born on October 29, 2013 (11
years old), a minor, who has an interest in the proceeds of insurance in
the life of the late , my deceased sister;

2. That the above mentioned minor is under my care and custody;

3. That there is no other judicially appointed guardian over the person or


property of the said minor;

4. That I am competent to receive on behalf of the said minor the


proceeds of insurance deceases sister at St. Peter Life Plan, Inc., any/all
amount due to her;

5. That I am of sound mind and body and that I am not a vagrant or


vicious person or habitual drunkard nor a criminal and has not
abandoned or neglected or refused to support said minor or caused her
to commit offenses against the law;

6. That I am executing this affidavit to attest to the foregoing facts and in


support of my insurance claim with St. Peter Life Plan, Inc.

IN WITNESS WHEREOF, I have hereunto set my hand this _____


day of May, 2025 at the City of Tagbilaran, Bohol, Philippines.

Affiant
TIN No.: 458-043-998-000

CORROBORATION

We, and , both of legal age, Filipinos and residents of Purok 3, Poblacion,
Dauis, Bohol, hereby confirm the foregoing statements of , to be true and
correct.

Affiant
Affiant
Driver’s License No. GO3-17-005449 Driver’s License No. GO3-00-052270

SUBSCRIBED AND SWORN to before me this _____ day of May, 2025 at


Tagbilaran City, Bohol, Philippines.

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