Affidavit of Insertion

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REPUBLIC OF THE PHILIPPINES )

TARLAC CITY ) S.S.

AFFIDAVIT OF INSERTION

I, MYRNA PAGALING-MATIAS, Attorney-in-fact of Romero P. Pagaling Jr. Ma.


Myla Pagaling-Montalbo and Myleen P. Pagaling, Filipino citizen, married, of legal age and
resident of #582 Brgy. A bagon, Gerona, Tarlac, after being duly sworn to in accordance
with law, depose and state: That - -

1. I, Romero P. Pagaling Jr., Ma. Myla Pagaling-Montalbo and Myleen P.


Pagaling are the legitimate3 children of Romeo R. Pagaling Sr. and Myrna P.
Pagaling in the Extra Judicial Settlement of Estate executed, notarized by Atty.
Francis Gil D. Guiang as per Doc. No. 387, Page No. 76, Book No. 23, Series
of 2019.

2. Unfortunately, my civil status as “married to Dennis Jerry Matias”, the civil


status of Romero P. Pagaling Jr. as “married to Lirio E. Pagaling”, the civil
status of Ma. Myla Pagaling-Montalbo as “married to Jhemil Montalbo” and
the civil status of Myleen P. Pagaling as “single” was not declared in the
above said document.

3. Through this affidavit, I hereby declare under oath that my civil status is
“married to REJIMA ACOSTA OSIANA” the civil status of Romero P.
Pagaling Jr. as “married to Lirio E. Pagaling”, the civil status of Ma. Myla
Pagaling-Montalbo as “married to Jhemil Montalbo” and the civil status of
Myleen P. Pagaling as “single” and request such to be inserted or declared in
the above said document.

4. I am executing this affidavit to attest to the truth and veracity of the foregoing
and for whatever legal purpose the same may serve;

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___________


Tarlac City.

MYRNA PAGALING-MATIAS
Affiant
SUBSCRIBED AND SWORN to before me _____________in Tarlac City.

Doc. No. ___;


Page No. ___;
Book No. ____;
Series of 2019.

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