Format On Joint Affidavit of Waiver
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rberoFormat On Joint Affidavit of Waiver
Uploaded by
rberoRepublic of the Philippines )
Province of __________ )
Municipality of ______ ) s.s.
JOINT AFFIDAVIT OF WAIVER OF RIGHTS
WE, PROCESO ________and ______, Filipino, of legal age, both married and
residents of Barangay _________________-, Philippines after having been duly sworn in
accordance with law, hereby depose and state:
1. That we are two of the legal heirs of the late MATILDE _______who died on December
21, 2018;
2. That our deceased mother was an insured member under Group Life Insurance of
COCOLIFE with Certificate Number 0010734;
3. THAT WE hereby WAIVE and RELINGUISH our rights, interest and participation over the
proceeds of such Life Insurance with COCOLIFE in favor of our youngest brother,
ROMULO ___________;
4. That we are executing this affidavit for all legal intents and purposes.
IN WITNESS HEREOF, WE hereby affix our signatures this 24th day of January, 2019 at
______________________.
PROCESO ___________ JULITO_________
Affiant Affiant
COMELEC VIN: ________ SSS ID, No: 03-78
SUBSCRIBED and SWORN TO before me on the date and at the place indicated above.
The affiant exhibited to me the following competent evidences of their identity indicated below
their names
WITNESS MY HAND AND SEAL in _______________.
ATTY. THURMAN
NOTARY PUBLIC
H______________
RTC 26-N.C. # _____ 2018 UNTIL DEC. 31, 2022
IBP LIFETIME ___________
PTR OR NO. __________
Roll No. ________
