The document is a waiver of rights form signed by heirs of a deceased veteran relinquishing any claims to unpaid medical and burial benefits from the Philippine Veterans Affairs Office (PVAO). The heirs state that the veteran passed away and had unclaimed benefits from PVAO. By signing the form, the heirs waive their rights to the deceased's benefits and release PVAO from any liability regarding the waiver. The form includes spaces for the heirs' names, relationships, signatures, and witnesses to sign.
The document is a waiver of rights form signed by heirs of a deceased veteran relinquishing any claims to unpaid medical and burial benefits from the Philippine Veterans Affairs Office (PVAO). The heirs state that the veteran passed away and had unclaimed benefits from PVAO. By signing the form, the heirs waive their rights to the deceased's benefits and release PVAO from any liability regarding the waiver. The form includes spaces for the heirs' names, relationships, signatures, and witnesses to sign.
The document is a waiver of rights form signed by heirs of a deceased veteran relinquishing any claims to unpaid medical and burial benefits from the Philippine Veterans Affairs Office (PVAO). The heirs state that the veteran passed away and had unclaimed benefits from PVAO. By signing the form, the heirs waive their rights to the deceased's benefits and release PVAO from any liability regarding the waiver. The form includes spaces for the heirs' names, relationships, signatures, and witnesses to sign.
The document is a waiver of rights form signed by heirs of a deceased veteran relinquishing any claims to unpaid medical and burial benefits from the Philippine Veterans Affairs Office (PVAO). The heirs state that the veteran passed away and had unclaimed benefits from PVAO. By signing the form, the heirs waive their rights to the deceased's benefits and release PVAO from any liability regarding the waiver. The form includes spaces for the heirs' names, relationships, signatures, and witnesses to sign.
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WAIVER OF RIGHTS
We, the undersigned, of legal age, heir/s of the late _, state that:
1. On ______________, __________________ passed away;
2. The deceased was a member of Philippine Veterans Affairs Office (PVAO) and has unclaimed member’s medical & burial at the time and after his death;
3. We are heirs of the deceased member;
4. We hereby waive all rights and interest that we may have over the benefits due the deceased from the PVAO;
5. We hereby release and forever discharge PVAO from any and all claim or liability from my co-heirs and/or any other third-party claimant in connection with the aforementioned waiver and release of the benefits in favor of the above-named person/s;
6. We are executing this affidavit to attest to the truth of the foregoing facts and statements.
7. Given are the name/s, relationship/s and signature/s of the heir/s of the deceased waiving his/her/their rights and interest over the benefits due from PVAO:
Name of Heir Relationship Signature
Witnesses:
_________________________ __________________________ Printed Name/Signature Printed Name/Signature SUBSCRIBED AND SWORN to before me this _______________________ by the following person/persons, who are known to me or whom I have identified through competent evidence of identity:
that he/she/they is/are the same person/s who personally signed before me the foregoing Waiver of Rights and acknowledged that he/she/they executed the same.
NOTARY PUBLIC
Doc. No. ____________;
Page No. ____________; Book No. ____________; Series of ____________.
