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    Affidavit of Guardianship

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    Tet Legaspi
    Maricar M. Balat executed an affidavit of guardianship for her five minor children - Lei Andrea B. Pinat, Liam Kent B. Pinat, Liam Kyle B. Pinat, Liam Kirk B. Pinat, and Liam Keith B. Pinat. She stated that the father of the children, PO2 Gersom Dadang Pinat Jr., died on September 8, 2016 and had an insurance policy with Public Safety Mutual Benefit Fund, Inc. Maricar will claim the benefits of the policy on behalf of the minor children. She also agreed to be liable for any claims against her representations and to refund any payments if required.

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    Affidavit of Guardianship

    Uploaded by

    Tet Legaspi
    525 views1 page
    Maricar M. Balat executed an affidavit of guardianship for her five minor children - Lei Andrea B. Pinat, Liam Kent B. Pinat, Liam Kyle B. Pinat, Liam Kirk B. Pinat, and Liam Keith B. Pinat. She stated that the father of the children, PO2 Gersom Dadang Pinat Jr., died on September 8, 2016 and had an insurance policy with Public Safety Mutual Benefit Fund, Inc. Maricar will claim the benefits of the policy on behalf of the minor children. She also agreed to be liable for any claims against her representations and to refund any payments if required.

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    Guardianship

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    Maricar M. Balat executed an affidavit of guardianship for her five minor children - Lei Andrea B. Pinat, Liam Kent B. Pinat, Liam Kyle B. Pinat, Liam Kirk B. Pinat, and Liam Keith B. Pinat. She stated that the father of the children, PO2 Gersom Dadang Pinat Jr., died on September 8, 2016 and had an insurance policy with Public Safety Mutual Benefit Fund, Inc. Maricar will claim the benefits of the policy on behalf of the minor children. She also agreed to be liable for any claims against her representations and to refund any payments if required.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    525 views1 page

    Affidavit of Guardianship

    Uploaded by

    Tet Legaspi
    Maricar M. Balat executed an affidavit of guardianship for her five minor children - Lei Andrea B. Pinat, Liam Kent B. Pinat, Liam Kyle B. Pinat, Liam Kirk B. Pinat, and Liam Keith B. Pinat. She stated that the father of the children, PO2 Gersom Dadang Pinat Jr., died on September 8, 2016 and had an insurance policy with Public Safety Mutual Benefit Fund, Inc. Maricar will claim the benefits of the policy on behalf of the minor children. She also agreed to be liable for any claims against her representations and to refund any payments if required.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Republic of the Philippines)

    Province of Masbate )
    City of Masbate )
    x----------------------------------x

    AFFIDAVIT OF GUARDIANSHIP

    I, MARICAR M. BALAT, Filipino, of legal age, and a resident of Market Site,


    Masbate City, after having been duly sworn to in accordance with law, hereby
    depose and state:

    1. That I am the mother of LEI ANDREA B. PINAT, 9 years old; LIAM KENT
    B. PINAT, 3 years old; LIAM KYLE B. PINAT, 2 years old and LIAM KIRK
    B. PINAT, 2 years old;
    2. That all the above-named children are under my care and custody and
    dependent upon me for support morally and financially;
    3. That however, my son in the name of LIAM KEITH B. PINAT, 7 years old,
    is currently under the custody of his grandmother, ELEONOR D. PINAT,
    as I entrusted the custody of the former to the latter when I got sick, and
    said child continues to be under the care and custody of his grandmother;
    4. That their father, PO2 GERSOM DADANG PINAT, JR., my common-law
    husband died on September 8, 2016 at Mandaon, Masbate
    5. That he has an insurance policy in Public Safety Mutual Benefit Fund,
    Inc.(PSMBFI) which has its principal office in 318-320 Santolan Rd., cor.
    1st and 2nd West Crame Streets, Brgy. West Crame, San Juan, Metro
    Manila;
    6. That I will be claiming the benefits under said policy in behalf of my
    minor children;
    7. That I shall be held liable to any person, that may be prejudiced by my
    representations, in addition to other liabilities, civil or criminal, that may
    arise therefrom; hereby releasing and discharging the Public Safety
    Mutual Benefit Fund, Inc.(PSMBFI) from any all further obligations in
    connection with this claim;
    8. That I further undertake to refund Public Safety Mutual Benefit Fund,
    Inc.(PSMBFI) the amount paid to me including interests thereon and
    indemnify PDIC, the bank and/or third parties for any loss or damages
    occasioned by such payment.
    9. That I am executing this affidavit to attest to the truth of the foregoing
    facts.

    IN WITNESS WHEREOF, I have hereunto affixed my signature this 18th day


    of July, 2017 at Masbate City, Philippines.

    MARICAR M. BALAT

    SUBSCRIBED AND SWORN TO before me this 18th day of July, 2017 at


    Masbate City, Philippines.

    Doc No. ____;


    Page No. ____;
    Book No. ____:
    Series of 2017.

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