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Affidavit of Dependency

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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF PANGASINAN ) S.S.


MUNICIPALITY OF LINGAYEN )

JOINT AFFIDAVIT OF DEPENDENT PARENT

We, JESUS P. BAUTISTA and REBECCA R. BAUTISTA, both of legal age,


and resident of Pangascasan, Bugallon, Pangasinan, after having been duly sworn to in
accordance with law, do hereby depose and say;

1. That we are the legitimate parents of JEJOMAR REYES BAUTISTA, a


member of the Social Security System;

2. That we are the beneficiary of JEJOMAR REYES BAUTISTA to his SSS


claims and benefits;

3. That we are dependent to our son for financial support during his lifetime;

4. That we are executing this affidavit to attest to the truth of the foregoing facts, and
for all legal purpose it may serve.

FURTHER, AFFIANT SAYETH NAUGHT.

JESUS P. BAUTISTA REBECCA R. BAUTISTA


Affiant Affiant
Senior Citizen ID Senior Citizen ID
Control No. 088689 Control No. 089902
Issued on 1/29/21 Issued on 9/27/22

SUBSCRIBED AND SWORN to before me this 11 th day of November, 2022, in


Lingayen, Pangasinan, affiants exhibiting to me their government issued IDs written
below their names as proof of their identity.

Doc. No.__
Page No.__
Book No.__
Series of 2022.

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