Republic of the Philippines )
) S.S.
AFFIDAVIT OF CONFIRMATION
I, DENNIS JR. ORTEGA AMUGUIS, a Filipino of legal age, a resident of Bulusan, Calapan City
Oriental Mindoro, a bona fide member of the Philippine National Police with the rank of Police
Lieutenant and presently assigned at PHAU after having been duly sworn to in accordance with
law, do hereby depose and says that:
1. Pursuant to this affidavit, I am confirming that the following are my legal beneficiaries
and/or heirs, to wit:
NAME
RELATIONSHIP
BIRTH DATE
DIONISIA ORTEGA AMUGUIS
MOTHER
DECEMBER 05, 1956
DAINIS ORTEGA AMUGUIS
BROTHER
MARCH 28, 1986
KRISTINE JOY ORTEGA AMUGUIS
SISTER
NOVEMBER 07, 1987
2. My relationship with persons whose names are listed above are borne out by the fact that
I am lawful son/daughter, sibling, spouse and the legitimate/illegitimate father/mother
of the afore named children as evidence by the attached marriage contract and birth
certificates;
3. I hold myself criminally and administratively liable for perjury and dishonesty should any
statements made herein are inaccurate or later on found to be false and in of law.
AFFIANT SAYETH NAUGHT:
DENNIS JR. ORTEGA AMUGUIS
Affiant
SUBSCRIBED AND SWORN to before me this ______ day of __________ at ______________
____________________________, Philippines.
Doc no.
Page no.
Book no.
Series no.
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