Republic of the Philippines)

__________________) S.S.

______________________________)

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AFFIDAVIT OF BENEFICIARY

I, _________, Filipino, of legal age, and a resident __________________, after being duly sworn to in accordance with law, hereby depose and state:

That I am the daughter of __________________ and _________________;

That to date, my civil status is single;

That I have not sired any child whomsoever;

That due to the fact that I am still single and have neither child nor any other dependent, I am instituting my parents _______________ and _____________ to be my beneficiaries for all the benefits I may be entitled to by virtue of my entry in the AFP;

As such, I am executing this Affidavit to attest to the truth of the foregoing and for all legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _________________ at _________________, Philippines.

____________________________________

Affiant

SUBSCRIBED AND SWORN to before me, this _________________ at ______________, Philippines.