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Joint Affidavit of Life Partnership of Norwin and Meryl

This joint affidavit establishes Norwin Somera and Meryl Gatchalian as life partners so that Somera can enroll in the company's parental leave benefit. They declare that they have lived together exclusively and continuously since 2016 at the stated address without legal impediment to marry. They agree to indemnify the company for any claims from third parties regarding benefits. They acknowledge that if their partnership ends, Somera will no longer be eligible for benefits applicable to a declared life partner.

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Norwin Somera
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2K views2 pages

Joint Affidavit of Life Partnership of Norwin and Meryl

This joint affidavit establishes Norwin Somera and Meryl Gatchalian as life partners so that Somera can enroll in the company's parental leave benefit. They declare that they have lived together exclusively and continuously since 2016 at the stated address without legal impediment to marry. They agree to indemnify the company for any claims from third parties regarding benefits. They acknowledge that if their partnership ends, Somera will no longer be eligible for benefits applicable to a declared life partner.

Uploaded by

Norwin Somera
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

CITY OF CABUYAO, LAGUNA ) S.S.

JOINT AFFIDAVIT OF LIFE PARTNERSHIP


We:

Name Citizenship Address

Norwin S. Somera Filipino B11 L23 Matalino St. Katapatan


Subdivision Bryg. Banay – Banay, City
of Cabuyao, Laguna

Meryl V. Gatchalian Filipino B11 L23 Matalino St. Katapatan


Subdivision Bryg. Banay – Banay, City
of Cabuyao, Laguna

both Single, of legal age, and of sound mind, after being sworn in accordance with law, hereby
jointly depose and say that:
1. Norwin S. Somera is an employee of Accenture, Inc., with office address at 23rd Floor Gateway
Tower 2 Cubao, Quezon City since Septemberober 28, 2015 to date;

2. We have been living together as life partners, in the same residential address, exclusively,
continuously and publicly since 2016, without the benefit of marriage and without any legal
impediment to marry under Philippine Laws.

3. We are executing this Affidavit for purposes of enrolling Norwin S. Somera to I&D Parental
Leave a which is one of the company’s benefits applicable to employees with a declared Life
Partner, subject to the policies and procedures of Accenture, Inc., until the Company revises,
replaces and/or discontinues such benefits or the beneficiary eligibility requirements therefor;

4. We hereby agree to indemnify the Company, its officers and affiliates, and hold it free and
harmless from all claims that may be filed all third persons (including the legitimate/illegitimate
heirs of the Life Partners) that may arise in relation to any Life Partner Benefits that may be
given to us by the Company;

5. We acknowledge that, in the event that our life partnership no longer meet the life partnership
criteria set forth by the company, we will no longer be considered Life Partners and Norwin S.
Somera will immediately file an Affidavit of Termination of Life Partnership with the Accenture
Benefits Admin. Accordingly, Norwin S. Somera will no longer be eligible for coverage or as
beneficiary to the roster of company benefits applicable to a declared Life Partner;

6. We understand that any false or misleading statement made to receive benefits for which we do
not qualify will subject us to financial responsibility for any benefits paid on us, jointly or
individually. In additions, Norwin S. Somera may be subjected disciplinary action up to and
including termination of employment and possible charges of fraud.
7. We attest, under pains and penalties of perjury, to the truth of the foregoing and for any legal
purpose it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands this ___ day of __________, _____, in
the City of _________, __________, Philippines.

________________________________________ ________________________________________
Affiant Affiant

Republic of the Philippines }


City of ________________ }

SUBSCRIBED and SWORN to before me, in the City of __________, __________, Philippines,
this ____ day of ________________ the affiants exhibiting to me the following:

Name Government ID/No. Issued on/at

Notary Public

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 20__.

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