AFFIDAVIT OF WAIVER OF RIGHTS

I, Amelita de Vera Beauregard, of legal age, married and with residence

address at __________________________do hereby depose and state:

1. That I am one of the heirs of Eleuterio S. de Vera who passed away

last September 11, 2013;
2. That I do hereby WAIVE my right, interest, and participation in the
claims of my father in GSIS, OSCA, and other government institution in
favor of our sister Marilyn Q. de Vera;
Affiant sayeth naught.

IN WITNESS WHEREOF , I have hereunto set my hand this _____day of

_______________ 20__, at __________________________________________

____________________________
Amelita de Vera-Beauregard

ACKNOWLEDGMENT

Republic of the Philippines )

_________________________) S.S

BEFORE ME, personally appeared me the following:

Name

Competent Evidence of Identity

Date/Place Issued

Known to me and to me known to be the same persons who executed the

foregoing instrument and acknowledged to me that the same is their free and
voluntary act and deed.

WITNESS MY HAND AND SEAL, on the date and place first above written.

Notary Public
Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.