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) S.S.
AFFIDAVIT OF UNDERTAKING
AND
The employer of the employee transferred in trust to the Philippine Embassy in DOHA
QATAR to transfer the amount of 12,703.00 Qatar Riyals as death /end of service
benefits (ESB) with authority given to the Department of Foreign Affairs (DFA) to
identify the NOK on the basis of appropriate Philippine Government documents ;
I, SALLEY SOBERANO ALVARADO the mother and legal guardian of minor children
of the employee, to receive the share of my minor children from the death benefits/ESB;
The NOK requests and authorized the Office of the Undersecretary for Migrant Workers
Affairs (OUMWA) to release the Philippine Peso equivalent of the death benefits/ESB
minus bank and other remittance charges as follows:
We hereby agree and authorize, for and on behalf of the estate of the Decedent ,the Office
of the Undersecretary for Migrant Worker Affairs (OUWWA) to direct the release of the
Philippine Peso (Php) equivalent of the whole amount of the blood money and insurance
benefits personally to NIEVES O.CONCEPCION.
We undertake to immediately distribute to the other legal heirs of the Decedent , who are
now known or who may be identified in the future,their respective shares in the said
amount , It if is discovered in the future that the whole or a portion of the said amount
was released erroneously to us,We undertake to return the said amount to OUMWA
within 10 days from notice.
The NOK affirms that they have no claim against the Department of Foreign Affair5s or
any of its officers or employees. IN the event that the another beneficiary surfaces , the
NOK shall free from harm and claim the Department of Foreign Affairs and defend
The latter against any proceedings that the new beneficiary may institute;
We are executing this affidavit- Undertaking to attest to the truth of the foregoing, and to bind
ourselves with the undertaking described herein. We understand that we may be prosecuted for
PERJURY,ESTAFA and other crimes for any material misstatement in this Affidavit, or for non
performance of this Undertaking.
IN WITNESS WHEREOF, I hereby affixed my signature this 25TH day of April 2019
Philippines.