This affidavit is made by the legal guardian of a minor child applying for survivorship benefits from the GSIS. The guardian attests that they are the [relationship] of the deceased GSIS member/retiree and that the child is under 18 years old. The guardian acknowledges that the child's benefits will terminate at age 18 and makes themselves liable for any payments received after that point. The guardian signs to affirm the truth of these statements in support of the child's application under Republic Act 8291.
This affidavit is made by the legal guardian of a minor child applying for survivorship benefits from the GSIS. The guardian attests that they are the [relationship] of the deceased GSIS member/retiree and that the child is under 18 years old. The guardian acknowledges that the child's benefits will terminate at age 18 and makes themselves liable for any payments received after that point. The guardian signs to affirm the truth of these statements in support of the child's application under Republic Act 8291.
This affidavit is made by the legal guardian of a minor child applying for survivorship benefits from the GSIS. The guardian attests that they are the [relationship] of the deceased GSIS member/retiree and that the child is under 18 years old. The guardian acknowledges that the child's benefits will terminate at age 18 and makes themselves liable for any payments received after that point. The guardian signs to affirm the truth of these statements in support of the child's application under Republic Act 8291.
This affidavit is made by the legal guardian of a minor child applying for survivorship benefits from the GSIS. The guardian attests that they are the [relationship] of the deceased GSIS member/retiree and that the child is under 18 years old. The guardian acknowledges that the child's benefits will terminate at age 18 and makes themselves liable for any payments received after that point. The guardian signs to affirm the truth of these statements in support of the child's application under Republic Act 8291.
OF MINOR DEPENDENT CHILD I, __________________________________________________________________, of legal age, Filipino, with address at ___________________________________________ and the following contact number _______________________, after having sworn in accordance with law, hereby depose and state: I am the __________________ (state relationship with the child, i.e. father/mother, etc.) and legal guardian of _____________ (name of child), a child of the late ___________________________________, who was a GSIS member / retiree, who died on ___________________ at _________________________________; I hereby declare that the above-named child is the youngest (or, second youngest/third youngest, etc.) of the deceased; that he/she is not more than 18 years of age. I am fully aware that if the said child is granted survivorship benefit by the GSIS, his/her entitlement thereto will automatically and permanently terminate the moment he/she is over eighteen. Consequently, I hereby unconditionally make myself personally and solidarily liable with the child for whatever survivorship benefit the latter may still unduly receive from the GSIS after his/her entitlement thereto is terminated as stated above. I am executing this affidavit to attest to the truth of the foregoing statements in support of the application for survivorship benefit of ___________ (name of child) under Republic Act No. 8291 and for what other legal purposes it may serve. I fully understand that any inaccurate and untruthful statement in this affidavit shall render me criminally and civilly liable. ______________________ Affiant SUBSCRIBED AND SWORN to before me this ______ day of _________________20__, in the City of Pasay, Philippines, affiant exhibiting to me his/her ______________________as Competent Evidence of Identity (CEI): NOTARY PUBLIC Doc. No. Page No. Book No. Series of
