We, _____________________ and ___________________, of legal age,
Filipino citizens and residents of ___________________________________________________, after having been duly sworn to in accordance with law that:
1) We are the children among six of +_________________ and
+____________________;
2) Our other siblings are _________________, who were not able to
travel in Manila for they have to attend other matters in the province such as taking medications;
3) _________________gave their oral consent to us in executing this
affidavit and to process the exhumation, cremation and re- interment of the remains of our mother;
4) Our mother died on _________________ and was buried at
_________________;
5) Our father died on _________________ and was buried at
_________________;
6) We agree that the bone remains of our mother will be exhumed,
cremated and interred at _________________;
7) We hereby give our full consent for their exhumation, cremation
and re-burial at _________________ so that both of our parents be buried in the same cemetery;
8) We hereby undertake and declare to agree that in the event
somebody will question or claim the bone remains of our parents who were buried in the aforesaid Memorial Park, we will be answerable and liable and further declare that the QUEZON CITY HEALTH DEPARTMENT will be free from any liability;
9) We hereby dispersed that Baesa Cemetery shall not be liable to
any person who may present a lawful claims on the above transaction we have undertaken to indemnify any such person who shall make a lawful claim on the same;
10) We are executing this affidavit to attest to the truth of the
foregoing facts and to support our request with Baesa Cemetery, Quezon City to allow the exhumation and re-burial of our parents for whatever legal purpose this affidavit may served; 11) We will process and attend to the necessary documentation of acquiring a permit to your office.
IN WITNESS WHEREOF, I have hereunto affixed my signature this