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Republic of the Philippines)

City of Iligan ) s.s.

AFFIDAVIT OF CONFIRMATION

I, HANS GROSS MCTHUNDER, Filipino, of legal age, married/single, a resident


of Purok Green Valley Brgy. Ubaldo D. Laya Iligan City, a bonafide member of the
Philippine National Police with the rank of Police Officer 1 (PO1) and presently assigned
at RPHAU, RPHRDD after having been duly sworn to in accordance with law, do hereby
depose and say that:

1. Pursuant to this affidavit, I am confirming that the following are my legal


beneficiaries and/or heirs, to wit:

NAME RELATIONSHIP BIRHTDATE


Rose Mcthunder Mother October 29, 1975
David Mcthunder Father July 30, 1964
Stella Mcthunder Daugther June 05, 2015

2. My relationship with person/s whose name/s is/are listed above are borne out
by the fact that I am the lawful spouse, legitimate/illegitimate father/mother,
legitimate/illegitimate son/daughter, or legitimate/illegitimate brother/sister of
the afore-named beneficiary/ies and/or heir/s, and as evidenced by the
attached marriage contract and/or birth certificate/s;

3. I hold myself criminally and administratively liable for perjury and dishonesty
should any statements made herein are inaccurate or later found to be false
and in of law.

AFFIANT SAYETH NAUGHT:

HANS G. MCTHUNDER
(Name and signature of affiant)
CTC No. 0456789
Issued on: January 04,2018
Issued at: Iligan City

SUBSCRIBED AND SWORN to before me this 23rd day of August, 2018 at


Iligan City, Philippines.

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