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.
