Affidavit of Status

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Republic of the Philippines)

City of Mandaue) S.S.

x-------------------------------------x

Affidavit

I, EUGENE K. AGRAVANTE, of legal age, married, Filipino citizen and a


resident of 327 South 89th Place, Mesa, Arizona, U.S.A. 85208, currently
sojourned at No. 27 Mahogany St., Greenplains Subd., Banilad, Mandaue City
after having been duly sworn to in accordance with law do hereby depose and
say:

1. That I previously executed a document entitled “Declaration of Heirs


with Waiver of Rights” dated February 13, 2015;

2. That in the said document, it is stated therein that I am married but


absent the name of my spouse Lorna G. Agravante;

3. That I attest to the truth that I am married and my wife’s name is Lorna
G. Agravante;

4. That 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 ___day of May


2015 in the City of Mandaue, Philippine.

EUGENE K. AGRAVANTE
Affiant
_______________

SUBSCRIBED AND SWORN to before me, this at Mandaue


City, with affiant showing his government issued ID appearing on the line below
his name.

WITNESS MY HAND AND SEAL.

Doc. No. : ________;


Page No. : ________;
Book No. : ________;
Series of 2015.

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