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AFFIDAVIT OF GUARDIANSHIP OF MINORS (for BANK

DEPOSITS)
REPUBLIC OF THE PHILIPPINES )
_____________________________ ) SS.
I, _____________________________, Filipino, of legal age, single/married
to _____________________________,
and
a
resident
of _____________________________, after having been duly sworn in accordance
with law, hereby depose and say:
1. I am the parent/court appointed guardian of _____________________________;
2. I am submitting a certified true copy of the Birth Certificate of the minor/court
appointment as guardian of said minor;
3. _____________________________ maintained Time
Deposit/Savings/Current Accounts
No/s. ___________________ with _____________________________ under the
account name _____________________________;
4. I, on behalf of _____________________________ hereby lay claim to the deposit
insurance due on the account;
5. I shall be held liable to any person, that may be prejudiced by my representations,
in addition to other liabilities, civil or criminal, that may arise therefrom; hereby
releasing and discharging the Philippine Deposit Insurance Corporation (PDIC) from
any all further obligations in connection with this claim;
6. I further undertake to refund PDIC the amount paid to me including interests
thereon and indemnify PDIC, the bank and/or third parties for any loss or damages
occasioned by such payment.
I am executing this affidavit to attest to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


____________ 20___ at ________________________, Philippines.
______________________________________
(Signature of Affiant over Printed Name)
SUBSCRIBED AND SWORN TO before me, a notary public in and for
_____________________ this ____ day of ____________ 20___. The affiant, whom
I
identified
through
the
following
competent
evidence
of
identity: _____________________________,
valid
from __________________
to __________________ issued by _____________________________, personally
signed the foregoing instrument before me and avowed under penalty of law to the
whole truth of the contents of said instrument.
Notary Public
Doc. No. ........;
Page No. .......;
Book No. .......;
Series of 20___.

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