Vous êtes sur la page 1sur 5

Assignment

June Agosto, of legal age, Filipino, a resident of Matina, Davao City, approached you to aid him
in the execution of the following affidavites:

1. He lost his ATM Card from Bank of the Philippine Islands with Card No 123-456789 last
December 5, 2018. He placed it in his room cabinet for safe-keeping, and when he tried to
retrieve it, he could not find it. (10 pts) - Required: AFFIDAVIT OF LOSS

2. He sired a son with Julia Abril, of legal age, Filipino and a resident of Sasa, Davao City
without the benefit of a valid marriage. The name of his son is “Hulyo Abril” (as registered in his
son’s Certificate of Live Birth) who was born last November 14, 2018. June Agosto wishes to
acknowledge paternity of his son and promise to give the latter support in an amount of Fifty
Thousand Pesos (P50,000.00) per month, whereby the payment will be deposited in the bank
account of Julia Abril (East West Savings Acct. No. 432-15642) by way of cash transfer every
month beginning on the date of the execution of the affidavit. (10pts) Required: AFFIDAVIT
OF ACKNOWLEDGMENT OF PATERNITY AND SUPPORT

3. On December 9, 2018, June Agosto parked his car at the Victoria Parking Lot in order that he
would buy grocery items thereat. After he returned to his parked car, he noticed that the front
bumper on his car was severely dented, and he could not ascertain the person responsible for
the same. Honesty Insurance, Inc. required June Agosto to execute the necessary affidavit in
order for him to claim his insurance proceeds under Insurance Policy No. 7A-B2234, which
covers his Toyota Fortuner 4x2 2.4L G DSL AT-B3 with plate number CCC 9990 registered under
his name with official receipt number 138887271. (10pts) Required: AFFIDAVIT OF
INSURANCE CLAIM
Republic of the Philippines )
Davao City ) S.S
X-----------------------------------X

AFFIDAVIT OF LOSS

I, JUNE AGOSTO, of legal age, Filipino, single, a resident of Matina, Davao City, after
having been duly sworn to in accordance with law, do hereby depose and state that:

1. I am the owner of the ATM Card No. 123-456789 issued by the Bank of the
Philippine Islands;
2. On December 5, 2018, I placed the same card inside my room cabinet for safe-
keeping purposes;
3. Sometime last week, I tried to retrieve it the same but discovered that it could no
longer be found;
4. Despite diligent efforts exerted, the same could no longer be located;
5. I am executing this affidavit to attest to the truth of the foregoing facts and to
request for the issuance of a new ATM Card in replacement of the one that was lost.

IN WITNESS WHEREOF, I hereunto set my hands this December 17, 2018 at Davao
City, Philippines.

JUNE AGOSTO
Affiant

SUBSCRIBED AND SWORN to before me this December 17, 2018 with affiant
exhibiting to me his competent evidence of identity through his PRC ID No. 123456
issued in Davao City on September 18, 2018.

Doc No. ___1___;


Page No. __1___;
Book No. __1___;
Series of 2018.

EUNICE L. AMBROCIO
PTR No. 9189180/06-25-2021/ Davao City
IBP Lifetime Roll No. 918918/05-25-2021/ Metro Manila
Roll No. 2008-000088
MCLE Compliance No. – Exempt
REPUBLIC OF THE PHILIPPINES )
DAVAO CITY )S.S
X--------------------------------------------X

AFFIDAVIT OF ACKNOWLEDGEMENT OF PATERNITY AND CHILD SUPPORT

I, JUNE AGOSTO, of legal age, Filipino, single, a resident of Matina, Davao City,
after having been duly sworn to in accordance with law, do hereby depose and state
that:
1. I am the biological father of the child Hulyo Abril, who was born last
November 14, 2018 at Davao City;
2. At the time of the child’s birth, I am not legally married to his mother, Julia
Abril;
3. I hereby admit/ acknowledge under oath the paternity of the child Hulyo
Abril;
4. I am hereby giving my consent to the minor child to use my surname and the
same be reflected in his birth certificate;
5. Being my biological son, I am giving him monthly support in an amount of
Fifty Thousand Pesos (P50,000.00) per month;
6. The said amount will be deposited to the East West Bank Account No. 432-
15642 of Julia Abril by way of cash transfer every month beginning on the
date of the execution of the affidavit.
7. I am willing and able to maintain support to my child financially.
8. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto set my hands this December 17, 2018 at Davao
City, Philippines.

JUNE AGOSTO
Affiant

SUBSCRIBED AND SWORN to before me this December 17, 2018, at Davao City,
Philippines with the affiant duly presenting his competent proof of identification, his PRC
ID No. 123456 issued in Davao City, Philippines on September 18, 2018.

Doc No. __2__;


EUNICE L. AMBROCIO
Page No. _1__;
PTR No. 9189180/06-25-2021/ Davao City
Book No. _1__; IBP Lifetime Roll No. 918918/05-25-2021/ Metro Manila
Series of 2018. Roll No. 2008-000088
MCLE Compliance No. – Exempt
REPUBLIC OF THE PHILIPPINES )
DAVAO CITY )S.S
X--------------------------------------------X

AFFIDAVIT OF INSURANCE CLAIM

I, JUNE AGOSTO, of legal age, Filipino, single, a resident of Matina, Davao City, after
having been duly sworn to in accordance with law, do hereby depose and state that:

1. I am the registered owner of the vehicle with the following details:


 Make/Model: Toyota Fortuner 4x2 2.4L G DSL AT-B3
 Plate Number: CCC9990

2. On December 9, 2018, I went to Victoria Plaza to buy groceries and parked my car
at the mall’s parking lot;
3. Upon my return, I noticed that the front bumper of the car has been severely
dented;
4. The persons responsible for such damage could not be identified despite efforts to
ascertain the same; and
5. I am executing this affidavit to attest the truth of the foregoing and in support of my
claim against the insurer, Honest Insurance, Inc., for the repair of the damage
caused to my vehicle.

IN WITNESS WHEREOF, I hereunto set my hands this December 17, 2018 at Davao
City, Philippines.

JUNE AGOSTO
Affiant

SUBSCRIBED AND SWORN to before me this December 17, 2018, with the affiant
duly presenting to me his competent proof of identity through his PRC ID No.
123456 issued in Davao City on September 18, 2018.

Doc No. __3__; EUNICE L. AMBROCIO


Page No. _1__; PTR No. 9189180/06-25-2021/ Davao City
Book No. _1__; IBP Lifetime Roll No. 918918/05-25-2021/
Series of 2018. Metro Manila
Roll No. 2008-000088
MCLE Compliance No. – Exempt

Vous aimerez peut-être aussi