Republic of the Philippines)

Cagayan de Oro City) S.s.

AFFIDAVIT OF SUPPORT
I, Ramonito N. Casino, Filipino, of legal age, and a resident of Paurom
Compound, San Martin, Villanueva, Misamis Oriental, after having been sworn
according to law, do depose and state:
1. That I am the seventh child of Vicentica N. Casino and the late Nathaniel G.
Casino;
2. That my mother, Vicentica N. Casino, is 81 years old;
3. That she has no visible means of support and is dependent, for her chief
support, on me;
4. That being dependent on me, I am using my PhilHealth Insurance to cover
her hospitalization expenses;
5. That I execute this affidavit to attest to the truth of the foregoing statements
and to support the use of my PhilHealth Insurance to cover her
hospitalization expenses.
Done this 1st of February 2016, Cagayan de Oro City.
RAMONITO N. CASINO
Affiant

Doc. No.:
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Book No.:
Series of 2016