REPUBLIC OF THE PHILIPPINES

)
City of xxx
) S.S.

AFFIDAVIT OF BENEFICIARY
I, _____, of legal age, single and a resident of _____after having been
duly sworn to in accordance with law hereby depose and state:
That I am an applicant for a position in the Philippine Army;
That I am currently unmarried and have no wife or children as my
dependent;
That considering that my legal status is single, my only living beneficiary
and dependent is my mother, ____;
And that I executed this affidavit to attest the truth of the foregoing and for
any other legal purpose/s it may serve.
IN TRUTH WHEREOF, I have hereunto signed my name below, this
____day of ______ at ________.
____________________
Affiant
SUBSCRIBED AND SWORN to before me this ___ day of ___, 2012 at
_____.

_______________________________
Public Attorney II
(Pursuant to R.A. 9406)