Waiver.insurance

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REPUBLIC OF THE PHILIPPINES )

MUNICIPALITY OF DAANBANTAYAN )S.S.

WAIVER OF RIGHTS

We, JOANNES PAULA B. ARREGLO, JOHN MATTHEW B. ARREGLO and


JULIA VIANEY B. ARREGLO Filipinos, of legal ages, and residents of
Daanbantayan, Cebu, Philippines after having been duly sworn to in accordance
with law do hereby depose and state that :

1. We are the heirs of the late EULOGIO P. ARREGLO who died


on September 2, 2021 at Daanbantayan, Cebu, Philippines;

2. That during his lifetime, he was an active member and a


lawful holder of St. Peter Life Plan with Contract No.
N12171202Q issued in his name and stead;

3. That we hereby waive, relinquish and renounce any and all


of our rights and interests whatsoever over the aforesaid
Life Plan Insurance in favor of our mother VIVIAN B.
ARREGLO;

4. We are executing this affidavit to confirm and affirm the


truth of the foregoing facts for the purpose of claiming the
Life Plan Insurance of our late father and for any lawful
purpose this may serve;

AFFIANT FURTHER SAYETH NONE.

IN WITNESS WHEREOF, WE have hereunto set our hand this ______day of


October 2024 in Daanbantayan, Cebu, Philippines.

JOANNES PAULA B. ARREGLO JOHN MATTHEW B. ARREGLO


Affiant/Heir Affiant/Heir
PRC I.D. No. 0870294 Passport I.D. P1915064

JULIA VIANEY B. ARREGLO


Affiant/Heir
Nat. ID No. 4613-8652-3982-7084

SUBSCRIBED AND SWORN TO before me this _________ day of October


2024 at Daanbantayan, Cebu, Philippines by affiant who exhibited to me their
evidence of identity and who is known to me to be the same persons who executed
the foregoing document and acknowledged that they freely executed the same.

Doc. No. ______;


Page No. ______;
Book No. ______;
Series of 2024

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