REPUBLIC OF THE PHILIPPINES]
SORSOGON CITY                ]
X-----------------------X
                  AFFIDAVIT COHABITATION
                  & GUARDIANSHIP OF MINOR
      I, JEANETTE ESTADOLA LACUIN, Filipino, of legal age, common law
wife of Mr. ROBERTO E. PEŃAFLOR JR., and a resident of Our Lady’s Village
OLV 1-A, Barangay Bibincahn, Sorsogon City, after having been duly sworn in
accordance with law, hereby depose and state:
       1. That I am the common law wife or live-in partner of Mr. ROBERTO E.
PEŃAFLOR JR. and the mother of the minor named below who has an interest in
the PISO PARA SA TUGANG (PPT) from the SORECO, which is a provident
benefits of the late ROBERTO E. PEŃAFLOR JR., payable by the SORECO;
      MINOR BENIFICIARY:
      Name                                             Date of Birth and Age
      KARL LAWRENCE L. PEŃAFLOR                        Jan. 21, 2009/11 yrs. old
       2. That I am the mother-guardian of the above-named minor. That I am
the common law wife or live-in partner of the late Roberto E. Peňaflor Jr. The
deceased and I met sometime in August 2000 and we started to cohabit with each
other as husband and wife in August of 2001. That out of our own cohabitation
we sired our first baby in the name of Karl Lawrence L. Peňaflor, as a matter of
fact the Certificate of Live Birth of the said child was duly acknowledged by the
deceased as his own child. Hereto attached as ANNEX “A”. That the
cohabitation lasted for almost seventeen (17) years until his early demise on May
31, 2020. (Attached herewith is the Death Certificate of Roberto E. Peňaflor Jr. to
prove the same, and is hereto marked and appended as ANNEX “B”;
      4. That the said minor is under my care and custody;
       5. That I am competent to receive in behalf of the said minor any amount
that are due him; and
       6. That I am not a stupid person, not an insane, not a vagrant and not a
vicious person;
      7. That I am not a habitual drunkard and not a habitual criminal;
      8. That I have neither abandoned, nor neglected and nor refused to
support said minor or caused him to commit offenses against the law;
         9. That I am executing this affidavit to attest to the truth of the foregoing
facts.
      IN WITNESS WHEREOF, I have hereunto affixed my signature this 9th
day of June, 2020, in Sorsogon City, Province of Sorsogon, Philippines.
                                             JEANETTE ESTADOLA LACUIN
                                                   Affiant/Guardian
       SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and
for in the City of Sorsogon, Province of Sorsogon, this 9th day of June 2020.
Affiant personally came and appeared with SSS ID No. 05—0855888-9 issued
by the Social Security System (SSS),     issued on ______________, issued at
________________, bearing her photograph and signature, known to me as the
same person who personally signed the foregoing instrument before me and
avowed under penalty of law to the whole truth of the contents of said
instrument.
Doc. No. ____;
Page No. ____;                                      NOTARY PUBLIC
Book No. ____;
Series of 2020. ;