REPUBLIC OF THE PHILIPPINES)

Nabua, Camarines Sur

) S.S.
AFFIDAVIT

WE, FELICITAS L. VELITARIO and SHIRLEY V. BAGASBAS, 88

years old and 57 years old, respectively, both Filipinos and both with
residence address at both residents of Santiago Old, Nabua, Camarines Sur
after having been sworn to in accordance with law, hereby depose and state
that:
1. That we are the nearest kin of the decedent, EDGARDO L. VELITARIO, who
died on July 21, 2014 at Betan-O, Sorsogon City, being the mother and sister
of the decedent, a copy of his death certificate is hereto attached as Annex
A;
2.

That the decedent is a member of the Social Security System (SSS);

3. That the decedent was married to Veneranda Repaso Velitario on

February 23, 1971 in Nabua, Camarines Sur and from that union they had five
children as follows to wit:
a. Darrel R. Velitario born January 8, 1972;
b. Jesusa R. Velitario born January 30, 1972;
c. Eva Grace R. Velitario born December 27, 1978;
d. April R. Velitario born April 3, 1980;
e. Marie Eda R. Velitario born January 29, 1982.
4. That the said decedent and Veneranda R. Velitario had been separated in
fact since 1984 due to marital differences including financial matters;
5. That after the separation the said decedent married his live-in partner
Elena Lato Velitario and from that union they had three children, to wit:
1. Edmundo C. Velitario born on July 19, 1985;
2. Edelyn L. Velitario born on January 1, 1990;
3. Evie L. Velitario born on July 23, 1995.
6. That the decedent has listed his beneficiary with SSS his second wife,
Elena Lato Velitario;
7.

That we know the foregoing facts because we his nearest kin;

8. That we are executing this affidavit to attest to the veracity of the

foregoing contents giving the authorities concerned and the correct data,
information and reference and for whatever legal purpose this may proper,
wise and equitable under the premises.
FURTHER AFFIANTS SAYETH NAUGHT.
_____________________
FELICITAS L. VELITARIO
Affiant
___________________
SHIRLEY V. BAGASBAS
Affiant
Postal ID No. 3685542
Valid until 7/25/2016
Issued by the Postal Administration of the Philippines

Nabua, C.S.
SUBSCRIBED AND SWORN to me this ___ day of August 2014 at Nabua,
Camarines Sur affiants known to me and to me known to be the same person
who personally executed the foregoing Affidavit and acknowledged before me
that the same is their free and voluntary act and deed.
Doc. No. ___
Page No. ___
Book No. ___
Series of 2014.