Pag Ibig Fpc011 Proof of Surviving Legal Heirs
Pag Ibig Fpc011 Proof of Surviving Legal Heirs
Pag Ibig Fpc011 Proof of Surviving Legal Heirs
8.
Date of Birth
Date of Birth
(d) Paternal and maternal grandparents in the absence of persons called for in items (b), and (c) above.
(e) Brothers and sisters in the absence of persons called for in items (b), (c) and (d) above. (Use another sheet if necessary) Name of Brother/Sister 1. 2. 3. Age Address Guardian of Minors
(f) Children of deceased brother/s and sister/s. (State age, address and guardian of minors) This is required only in the absence of items (b), c) and (d).
The undersigned hereby make claim to the Pag-IBIG provident benefits and agree that the written statements and affidavits and all other papers called for the instructions hereon shall constitute and they are hereby made a part of these Proofs of Surviving Legal Heirs and further agree that the furnishings of the form or any other forms supplemented thereto, to said Pag-IBIG Fund shall constitute nor be considered an admission by it that the deceased was entitled to the retirement provident benefits under PD 1530 as amended by PD 1752, as amended by Executive Order No. 90, further amended by RA 7742; nor a waiver of any of its right or defenses.
____________________________ SPOUSE
_____________________________ SPOUSE
___________________________ SPOUSE
__________________________________________
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ACKNOWLEDGMENT
BEFORE ME, a Notary Public for and in the______________________________________ this __________ day of _________________________________, 20_________, personally appeared the above-named persons with their identifying documents written below their names and signatures , personally known to me and to me known and identified by me through competent evidence presenting this integrally complete instrument. Representing to me that the signatures in the instrument were voluntarily affixed by them for the purposes declaring that they have executed the instrument as their free and voluntary act and deed. Further, persons acting in representative capacity declare that they have been given authority to sign in said capacity. The foregoing instrument relates to a Proofs of Surviving Legal Heirs consisting of ________ (___) pages including this page of Acknowledgment, signed by the parties and their instrumental witnesses on all pages thereof, in my presence, and sealed with my Notarial Seal. WITNESS MY HAND AND NOTARIAL SEAL. NOTARY PUBLIC Doc. No. _________; Page No. _________; Book No._________; Series of _________.