lTE FILING PVAO
lTE FILING PVAO
lTE FILING PVAO
I, HENRY F. GONZALES, of legal age Filipino, with residence address at Brgy. Abogado,
Paniqui, Tarlac, after having sworn to in accordance with law do hereby deposes and state:
1. That I am honorably discharged from the defunct Philippine Constabulary (PC) within
which I rendered nine (9) years, more or less, in the service holding the rank of
Sergeant;
2. That upon reaching 65 years old, I was supposed to file an application for old age
pension with the Philippine Veterans Affairs Office (PVAO), but due to recurring health
conditions, such as diabetes, vertigo and mild stroke, the filing of such claims has been
delayed for ten years as I am now 75 years of age.
3. That I would like to request the PVAO that the delayed filing of my pension claim with
the PVAO was not intentional but due to above happenstances. Further, I would like to
request that such delayed be justified as I am in dire health and requires funds to
support my medication. Any assistance will be extended by PVAO will be highly
appreciated.
4. That I am executing this affidavit to attest to the truth of the foregoing instrument and
for any legal purpose and intents this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 22 nd day of June, 2021 in
Quezon City.
HENRY F. GONZALES
Affiant
ID No. _____________
Issued on __________
Issued by ___________
SUBSCRIBED AND SWORN TO before me this 22nd day of June, 2021 in Quezon
City. Affiant exhibited to me his/her Identification documents as proof of his/her
identity.
Doc. No._____
Page No._____
Book No._____
Series of 2021.