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Republic of The Philippines) Quezon City, Metro Manila) 'S.S

This affidavit details an agreement by an individual to divide and share equally a Php 5,000 benefit received from the Quezon City government under Ordinance SP No.2544 S2017 for the death of a senior citizen. The individual agrees to indemnify the city government for any claims against the benefit within 2 years, after which the obligation will be null and void. The affidavit was signed and sworn to on a specified date in Quezon City.

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740 views1 page

Republic of The Philippines) Quezon City, Metro Manila) 'S.S

This affidavit details an agreement by an individual to divide and share equally a Php 5,000 benefit received from the Quezon City government under Ordinance SP No.2544 S2017 for the death of a senior citizen. The individual agrees to indemnify the city government for any claims against the benefit within 2 years, after which the obligation will be null and void. The affidavit was signed and sworn to on a specified date in Quezon City.

Uploaded by

jaden_sumaoang
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines}

Quezon City, Metro Manila} `S.S.

AFFIDAVIT OF UNDERTAKING AND COMMITMENT


I, ________________________________________, of legal age, single/married,
residing at _______________________________________________________,
after having sworn in according law, hereby depose and say:

That I am one of the bereaved member of the family of the


late______________________________________________________________
who died on ______________________in ______________________________
That the bereaved surviving relative of the senior citizen has benefit from
Quezon City government under Ordinance SP No.2544 S2017 in the amount of
Php. 5,000.00.

That I being the claimant/recipient agreed and WILLING TO DIVIDE the


above mentioned benefit/claimed from the Quezon City government, in equal
shares partly or wholly for any other claimants that may arise other than myself.

That I undertake and hereby commit myself to answer/indemnify any all


just claim/s that maybe filed against the above mentioned benefits claim if any, and

That I hereby bind myself in favor of the Quezon City government to


answer damages which it may suffer arising to any and all claims against said
benefit/ claim and that should no claim presented within (2) years, obligation shall
be null and void.

IN WITNESS WHEREOF, we have her unto set our hands in this


______day of ___________in Quezon City.

_______________________

AFFIANT

ID No. _________________
Issued on. _______________
at ______________________

SUBSCRIBED AND SWORN to before me this ________ day of


____________ at ________________________.

DOC NO. ___________


PAGE NO. _________
BOOK NO. __________
Series of. ____________
Revised form 15th March 2021

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