Republic of the Philippines ) City of Cabadbaran ) S.S. x--------------------------x
AFFIDAVIT OF GUARDIANSHIP I, CRESENTE E. JUSAYEN, of legal age, married, Filipino citizen, and presently residing at P-9, Barangay Calamba, Cabadbaran City, Agusan del Norte, after having been duly sworn to in accordance with law, do hereby depose and say: 1. That I am the grandfather and guardian of the following minors who have an interest in applying for a DOST Scholarship and for whatever legal intent: Full Name of Minor/s KARLO J. AVENIDO
Date of Birth August 24, 1999
Age 17
2. That the above mentioned minors are under my care and custody; 3. That I am competent to certify in behalf of their parents in their application for DOST Scholarship and for whatever legal purpose; 4. That I am not an imbecile, insane, a vagrant or a vicious person or a habitual drunkard or a habitual criminal, and have not abandon ed, neglected or refused to support said minors or caused them to commit offenses against the law. 5.
That I am executing this affidavit to attest to the truth of all the foregoing statements and for whatever legal purpose it may serve. IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at Cabadbaran City, Agusan del Norte, Philippines.
CRESENTE E. JUSAYEN Affiant SUBSCRIBED AND SWORN to before me this ________________ at Cabadbaran City, Agusan del Norte, Philippines, affiant exhibiting to me his competent evidence of identity _____________________________.
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Republic of the Philippines ) City of Cabadbaran ) S.S. x--------------------------x AFFIDAVIT OF GUARDIANSHIP
I, ROSITA MAHINAY LOPEZ, of legal age, married, Filipino citizen, and presently residing at Purok 1, Santiago, Agusan del Norte, after having been duly sworn to in accordance with law, do hereby depose and say: 1. That I am the grandmother and guardian of KYLIE LOPEZ, who was born on July 31, 2000, and is now 17 years old, who has an interest in applying for a DOST Scholarship and for whatever legal intent; 2. That the above mentioned minor is under my care and custody; 3. That I am competent to certify in behalf of her parents in her application for DOST Scholarship and for whatever legal purpose; 4. That I am not an imbecile, insane, a vagrant or a vicious person or a habitual drunkard or a habitual criminal, and have not abandoned, neglected or refused to support said minor or caused her to commit offenses against the law. 5. That I am executing this affidavit to attest to the truth of all the foregoing statements and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 24th day of August 2017 at Cabadbaran City, Agusan del Norte, Philippines.
ROSITA MAHINAY LOPEZ Affiant SUBSCRIBED AND SWORN to before me this 24th day of August 2017 at Cabadbaran City, Agusan del Norte, Philippines, affiant exhibiting to me her Voter’s ID No. _______________________________.
Doc No. : Page No.: Book No.: I Series of 2017
