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Affidavit of Waiver of Claim of Burial Benefits

AAA is filing an affidavit waiving his rights and claims to any GSIS benefits from his late wife EEE, who passed away in [City]. AAA is the surviving spouse, but the burial receipts were issued under their daughter CCC. AAA wants CCC to be able to claim and process the GSIS benefits on his behalf. AAA signed the affidavit to attest to these facts.

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20K views1 page

Affidavit of Waiver of Claim of Burial Benefits

AAA is filing an affidavit waiving his rights and claims to any GSIS benefits from his late wife EEE, who passed away in [City]. AAA is the surviving spouse, but the burial receipts were issued under their daughter CCC. AAA wants CCC to be able to claim and process the GSIS benefits on his behalf. AAA signed the affidavit to attest to these facts.

Uploaded by

GP Buhangin
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)

IN THE CITY OF ) SS.


X---------------------X

AFFIDAVIT OF WAIVER OF CLAIMS

I, AAA, Filipino, of legal age, widower and a resident of City , Philippines,


after having been sworn in accordance with law, upon my oath do hereby state:

1. That I am the surviving spouse of the late EEE who died on ________ at
________ City;

2. That my deceased wife was a GSIS member;

3. That the official receipts for the interment and burial expenses of my late
wife were issued in the name of one of our children namely CCC and I would
like my daughter CCC to claim and process the GSIS benefits of EEE;

4. That I am waiving my rights and claims and whatever GSIS benefits


that I may receive in favor of my daughter CCC;

5. I am executing this affidavit to attest to the truth of the foregoing facts and
for whatever legal purpose it may serve.

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


_________ City, Philippines.

AAA
Affiant

SUBSCRIBED AND SWORN to before me this _____________ at Davao City,


Philippines, with affiant exhibiting to me his Professional Driver’s License with Nos.
____, a competent proof of his identity.

Doc. No. ______ ;


Page No. ______;
Book No. ______;
Series of 2021.

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