Affidavit Of Waiver-chi Chi Arac.docx

REPUBLIC OF THE PHILIPPINES ) City of Tagbilaran

) S.S.

AFFIDAVIT OF WAIVER I, CHI CHI VILLAROMAN ARAC, of legal age, Filipino, married and a resident of Purok 7, Upper Songculan, Dauis, Bohol after having been duly sworn to in accordance with law, depose and say: That I am one of the beneficiaries of Life Plan Plus Agreement of St. Peter Life Plan; That the St. Peter Life Plan of my father APOLINARIO VILLAROMAN has a pre-need price and has a return of premium incorporated in the said plan under Contract No. R06349705 and Plan Type ST. DOROTHY which is now due and demandable; That I hereby relinquish whatever rights due to me in favor of CORAZON G. VILLAROMAN, legal wife of the member who is my mother; That this affidavit is executed freely and voluntarily in our own will and volition; That we are executing this affidavit to attest the truth and veracity of the foregoing and for whatever legal purpose it may serve;

IN WITNESS WHEREOF, we have hereunto set our hands this _______________ at City of Tagbilaran, Bohol, Philippines.

CHI CHI VILLAROMAN Affiant

ARAC

SUBSCRIBED AND SWORN to before me, this __________________, by the affiant whom I have identified through competent evidence of identity and who exhibited his/her SSS UMID Identification Card No. CRN-00092144910-6 issued at Tagbilaran City, Bohol.