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REPUBLIC OF THE PHILIPPINES )
City of Valenzuela          ) SS.


                                    AFFIDAVIT
                         (RE: GUARDIANSHIP OF INCOMPETENT)



       I, ________, of legal age, married, Filipino, and                                     residing at
_______________________________________________, after being                                 duly sworn
according to law, depose and say:

         1. That I am the legitimate spouse of the incompetent _____________ who has an
            interest in the proceeds of claim for disability/sickness benefit payable by the
            Social Security System;

         2. That the above-mentioned incompetent is under my care and custody and
            presently confined at ______________;

         3. That I am competent to receive in behalf of the said incompetent the amount(s)
            due him as disability/sickness benefit of the subject member of the social
            Security System;

         4. That I am not an imbecile, insane, vagrant or vicious person or habitual
            drunkard or habitual criminal, and have not abandoned, neglected or refused to
            support said incompetent or caused him to commit offense against the law;

         5. That the amount due the incompetent named above does not exceed
            ___________________ PESOS (P________).



                                                        _______________________________
                                                                   Affiant

--------------------------------------------------------------------------------------------------

                                    CORROBORATION

(To be accomplished by two disinterested persons who are prominent in the community)


       We, ________, of legal age, married, Filipino, and residing at
_______________________________________________,       and    _____________
________,     of     legal   age,   married, Filipino,   and   residing     at
_______________________________________________, hereby confirm the foregoing
statement Mr./Mrs. ___________________.



        SUBSCRIBED AND SWORN to before me this ____ th day of ______, 20__ in
________________, Philippines, affiant exhibited to me their Community Tax Certificate
as follows:

         Name                       C.T.C. No.                          Date and Place Of Issue
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 200_.

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Affidavit guardianship of incompetent

  • 1. REPUBLIC OF THE PHILIPPINES ) City of Valenzuela ) SS. AFFIDAVIT (RE: GUARDIANSHIP OF INCOMPETENT) I, ________, of legal age, married, Filipino, and residing at _______________________________________________, after being duly sworn according to law, depose and say: 1. That I am the legitimate spouse of the incompetent _____________ who has an interest in the proceeds of claim for disability/sickness benefit payable by the Social Security System; 2. That the above-mentioned incompetent is under my care and custody and presently confined at ______________; 3. That I am competent to receive in behalf of the said incompetent the amount(s) due him as disability/sickness benefit of the subject member of the social Security System; 4. That I am not an imbecile, insane, vagrant or vicious person or habitual drunkard or habitual criminal, and have not abandoned, neglected or refused to support said incompetent or caused him to commit offense against the law; 5. That the amount due the incompetent named above does not exceed ___________________ PESOS (P________). _______________________________ Affiant -------------------------------------------------------------------------------------------------- CORROBORATION (To be accomplished by two disinterested persons who are prominent in the community) We, ________, of legal age, married, Filipino, and residing at _______________________________________________, and _____________ ________, of legal age, married, Filipino, and residing at _______________________________________________, hereby confirm the foregoing statement Mr./Mrs. ___________________. SUBSCRIBED AND SWORN to before me this ____ th day of ______, 20__ in ________________, Philippines, affiant exhibited to me their Community Tax Certificate as follows: Name C.T.C. No. Date and Place Of Issue
  • 2. Doc. No. _____; Page No. _____; Book No. _____; Series of 200_.