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Annex A IS ISIS Form No. SURV-2011-02-003 Date Revised: 2010-03-16 REPUBLIC OF THE PHILIPPINES) PASTY CITY)S.S. AFFIDAVIT OF LEGAL/CERTIFIED GUARDIAN OF INCAPACITATED DEPENDENT CHILD I, of legal age,
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GSIS PASAY SURV-2011-02-003 2010 solidarily CEI invalidly PTR IBP Affiant survivorship retiree civilly untruthful foregoing erroneously Dec SUBSCRIBED unconditionally depose herein attest renders inaccurate exhibiting NOTARY criminally executing Annex INC

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