AFFIDAVIT OF LOAN DENIAL
I, AIDA GARCIA SY, of legal age, Filipino, widow and a resident of 44-8 First Park
Subdivision, Sagpon, Daraga, Albay after having been duly sworn to in accordance with law,
depose and state:
1. That I am a pensioner of Government Services Insurance System (GSIS);
2. That sometime in February, 2017, I was assisted by my daughter, Maria Jessamine G. Sy to
update my GSIS member’s information and to inquire for other programs of the agency
intended for the pensioner’s;
3. That my daughter upon learning that I have outstanding loan with the agency, immediately
inquire at the information desk of GSIS Legazpi City Branch to secure a copy of the loan
application details;
4. That it was stated in the loan application details that the said loan in the amount of twenty
thousand pesos (P 20,000.00) was applied on August 7, 2014;
5. That I hereby unequivocally deny applying the said loan and received the proceeds thereof
on August 8, 2014;
6. That it is the policy of the GSIS to a pensioner to avail of any loan, the pensioner must
personally apply the loan to any branch office of GSIS and fill-up a form to avail thereof which I
do not have;
6. That I am executing this Affidavit of Loan Denial to attest to the foregoing facts and to deny
absolutely and entirely that I have availed and received the loan proceeds in the amount of
twenty thousand pesos only and for all legal intents and purposes.
IN WITNESS WHEREOF, I hereby affixed my signature this 20th day of April, 2017 in
Daraga, Albay, Philippines.
AIDA GARCIA SY
Affiant
SUBCRIBED AND SWORN TO before me this _____________ in
______________, Philippines, affiant exhibiting to me his/her competent evidence of identity
by way of ______________ issued at _____________ on ______________.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2017.