Joint-Affidavit of Waiver

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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S.S


CITY OF TUGUEGARAO )

JOINT-AFFIDAVIT OF WAIVER OF THE HEIRS OF LORETO R. AZUCENA

We, FELICIANO J. AZUCENA, NICOLAS J. AZUCENA, JOSELITO J. AZUCENA,


ARNOLD J. AZUCENA and JANET A. MUÑOZ, all of legal age, Filipinos and residents of
Gumarueng, Piat, Cagayan, after having been duly sworn to in accordance with law, do hereby
depose and state:

1. That we are the surviving legal and compulsory heirs of the late LORETO R.
AZUCENA, our father, who died on October 30, 2019 at Gumarueng, Piat, Cagayan;

2. That we hereby declare that during his lifetime, we incurred expenses particularly for his
medications and hospitalization. This is aside from the expenses we also incurred during
and after his death;

3. That knowing that our father was a life member of the Veterans Federation of the
Philippines, we requested and sought reimbursements of our above hospital and
medication expenses at the Veterans Memorial Medical Center, Philippine Veterans
Affairs Office (PVAO), Manila;

4. That PVAO granted our request and issued a LandBank Check bearing number
0001776105 with a face value of One Hundred Five Thousand One Hundred Six Pesos
and Seven Centavos (P105, 106.07) in the name of our late father, Loreto R. Azucena;

5. As part of extra-judicial settlement of the estate of our late father, we are voluntarily
waiving all our rights, claims and interest over the above money claim
(reimbursement) from PVAO in favor of our sibling, JANET A. MUÑOZ;

6. That we are likewise waiving whatever existing and pending claims that we have
from PVAO arising from the reimbursements of our father’s expenses during his
hospitalization and medications;

7. We are executing this joint-affidavit to attest the truthfulness of the foregoing facts as to
and for whatever intents and purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand, this 20 th day of January 2020, at
Tuguegarao City, Cagayan.

FELICIANO J. AZUCENA NICOLAS J. AZUCENA


Heir Heir
TIN 135-228-521-000 LTO LICENSE ID NO.B04-05-001710

JOSELITO J. AZUCENA ARNOLD J. AZUCENA


Heir Heir
TIN 476-922-284-000 UMID ID CRN 0033-7634027-1

JANET A. MUÑOZ
Heir/Recipient
UMID CRN 0003-7826787-6

SUBSCRIBED AND SWORN TO before me, this 20th day of January 2020, at Tuguegarao City,
Cagayan. Affiants-heirs exhibiting to me their respective valid identification cards as competent
proof of their identity.
.

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