Republic of the Philippines )

Cainta, Rizal ) S.S.

AFFIDAVIT OF LEGAL GUARDIANSHIP

I, Maricris Buiza Batanes, Filipino, of legal age,

married, sibling of Mervin Completo Buiza, and with
residence at No. 19 M. Vicencio Street, Felix Subdivision,
Brgy. San Andres, Cainta, Rizal, Philippines, after having
been duly sworn to in accordance with law, do hereby
depose and state, THAT:

1. I am the sister of recently deceased Mervin

Completo Buiza. Who is insured by Colonial Pension
Services with membership identification number 120-11-
1815 and covered by insurance plan number 15332;

2. Mervin Completo Buiza was survived by his only

son, Mervin Joshua Estanislao Buiza, and indicated
the latter as his beneficiary;

3. Mervin Completo Buiza left his son under my

care and guardianship since the latter’s birth because he
has to work abroad;

4. Mervin Joshua Estanislao Buiza has been under

my guardianship for the past 14 years and up to this
present day;

5. I am executing this affidavit to attest to the

foregoing declaration, as proof that the undersigned affiant
is the true legal guardian of Mervin Joshua Estanislao
Buiza, and for purposes not contrary to law, morals, good
custom, and public policy.

IN WITNESS WHEREOF, I have hereunto affixed

my signature this 17th of January, 2018 in Cainta, Rizal,
Philippines.

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 Maricris Buiza Batanes
Affiant

SUBSCRIBED AND SWORN TO before me on the

date and at the place above-written. Affiant exhibiting to
me her Philippine Passport EC0125934, as competent
proof of identity

Doc. No. ;
Page No. ;
Book No. ;
Series of 2018.

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