REPUBLIC OF THE PHILIPPINE)

IN THE ______________________
)Sc.
X------------------------------------------X

AFFIDAVIT OF GUARDIANSHIP
I, __________________________________ , of legal age, Filipino, ___________
and a resident of _______________________________________________, after
having been duly sworn to law, depose and state:
1. That I am the same and identical person named above who is
____________________
________________________
who
died
on
_____________________________________
_______________________;
2. That at the time of his death he left a minor child in the name of
__________________
___________________;
.

3. That I am the guardian of said ________________________________,

being the ___________________________________;

4. That I am executing this affidavit to attest to the truth of the

foregoing statements.
IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of
____________ 2013 at________________________________, Philippines.

___________________________
(Affiant)
SIGNED IN THE PRESENCE OF:
1. _____________________________
__________________________
SUBSCRIBED AND SWORN to before me this _______ day
_____________ 2013, at _________________________________, Philippines.

Doc. No. _______

Page No. ______
Book No. X
Series of 2013

2.

of