Republic of the Philippines )

Province of Cavite ) S. S.
City of Dasmarias )
x--------------------------------x

AFFIDAVIT OF LEGAL BENEFICIARY

I, JOMAR A. NABUA, of legal age, single, Filipino and a resident

of Blk 12 Lot 15 Brgy. Fatima 1, Ph 2, Dasmarias City, Cavite, after
having been duly sworn to in accordance with law, hereby depose and
say:

1. That I am applying in the Military Service as trainee in the

Philippine Army;

2. That as one of my requirements, I am declaring the following

persons as my legal beneficiaries;
ARNOLD M. NABUA - father
JOHN PAUL A. NABUA - brother
JESTER MANUEL B. NABUA- nephew

3. That I am executing this affidavit to attest to the truth of the

above-statement for whatever legal purposes that this affidavit it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 14th

day of July 2017 at Dasmarias City, Cavite.

JOMAR A. NABUA
Affiant

SUBSCRIBED AND SWORN to before me this 14th day of July 2017 at

Dasmarias City, Cavite.

Doc. No.
Page No.
Book No.
Series of 2017.