Republic of the Philippines

Quezon City

)
) S.S.
AFFIDAVIT OF LEGAL HEIRS WITH
WAIVER OF RIGHTS AND RELEASE

I, MA. ELENA ACEJO SILVINO of legal age, Filipino and with residence address at B-49 L-11
Area H Phase I CSJDM, Bulacan, after being duly sworn to in accordance with law, deposes and state:

1. That I am the surviving wife of the late SPO3 CARMELITO SILVINO, who passed away on
January 5, 2016 at Caloocan City;

2. Said deceased died without leaving any Will nor Debts in favor of any person or entity;

3. The deceased left a CAPITAL CONTRIBUTION/SAVINGs Account in the Air Material Wing
Savings and Loan Association, Inc. (AMWSLAI) under Account No0. 001-10-018071-9;

4. That for love and affection I hereby waive all my rights and interest in favor of KRISTINA
SILVINO SANTIAGO;

5. I, hereby undertake and assume the responsibility in case anybody would claim the said
CAPITAL CONTRIBUTIONS/SAVINGS ACCOUNT; and

6. I, hereby relieve AMWSLAI, its Officers and Employees from any administrative and / or civil
liabilities that may incur upon the release of such claim/benefit/account.

IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of July 2016, in Quezon City.

MA. ELENA ACEJO SILVINO

Affiant

With my acceptance

KRISTINA SILVINO SANTIAGO

Signed in the presence of:

____________________
Republic of the Philippines
Quezon City

_____________________

)
) S.S

ACKNOWLEDGEMENT
BEFORE ME, a notary public for and in _________________personally appeared:
Name
ID No. Issued on /at
MA. ELENA ACEJO SILVINO
KRISTINA SILVINO SANTIAGO
Known to me and to me is known to be the same persons who executed the foregoing instrument
and they acknowledged to me that the same is their free and voluntary acts and deed.
WITNESS MY HAND AND NOTARIAL SEAL, on the date and place first above written.

Doc. No.______;
Page No. ______;
Book No.______;
Series of 2016.

NOTARY PUBLIC