7/24/2019 Sample Affidavit of Support
1/1
Republic of the Philippines)
Cagayan de Oro City) S.s.
AFFIDAVI OF S!PPOR
I" Ra#onito $. Casino" Filipino" of legal age" and a resident of
Pauro#
Co#pound" San %artin" Villanue&a" %isa#is Oriental" after
ha&ing been s'orn
according to la'" do depose and state(
. hat I a# the se&enth child of Vicentica $. Casino and the
late $athaniel *.
Casino+
,. hat #y #other" Vicentica $. Casino" is - years old+
. hat she has no &isible #eans of support and is dependent"
for her chiefsupport" on #e+
/. hat being dependent on #e" I a# using #y Phil0ealth Insurance
to co&er
her hospitali1ation e2penses+
3. hat I e2ecute this affida&it to attest to the truth of
the foregoing state#ents
and to support the use of #y Phil0ealth Insurance to co&er
her
hospitali1ation e2penses.
Done this stof February ,45" Cagayan de Oro City.
RA%O$IO $. CASI$O
Affiant
Doc. $o.(
Page $o.(
6oo7 $o.(
Series of ,45
