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    Affidavit of Non-Acceptance

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    JunivenReyUmadhay
    JSUPT Samson P Abaygar retired from the Bureau of Jail Management and Penology in May 2013. As a member of the Armed Forces and Police Mutual Benefit Association, he has not received his policy contract. He is submitting this Affidavit of Non-Acceptance to support his claims for terminal benefits and cash surrender value from the association since he has not accepted the terms of any policy contract. The affidavit asserts these facts to support his processing of benefits from the organization.

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    Affidavit of Non-Acceptance

    Uploaded by

    JunivenReyUmadhay
    3K views1 page
    JSUPT Samson P Abaygar retired from the Bureau of Jail Management and Penology in May 2013. As a member of the Armed Forces and Police Mutual Benefit Association, he has not received his policy contract. He is submitting this Affidavit of Non-Acceptance to support his claims for terminal benefits and cash surrender value from the association since he has not accepted the terms of any policy contract. The affidavit asserts these facts to support his processing of benefits from the organization.

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    affidavit of Non-Acceptance

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    JSUPT Samson P Abaygar retired from the Bureau of Jail Management and Penology in May 2013. As a member of the Armed Forces and Police Mutual Benefit Association, he has not received his policy contract. He is submitting this Affidavit of Non-Acceptance to support his claims for terminal benefits and cash surrender value from the association since he has not accepted the terms of any policy contract. The affidavit asserts these facts to support his processing of benefits from the organization.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    3K views1 page

    Affidavit of Non-Acceptance

    Uploaded by

    JunivenReyUmadhay
    JSUPT Samson P Abaygar retired from the Bureau of Jail Management and Penology in May 2013. As a member of the Armed Forces and Police Mutual Benefit Association, he has not received his policy contract. He is submitting this Affidavit of Non-Acceptance to support his claims for terminal benefits and cash surrender value from the association since he has not accepted the terms of any policy contract. The affidavit asserts these facts to support his processing of benefits from the organization.

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    © All Rights Reserved
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    of 1

    REPUBLIC OF THE PHILIPPINES)

    CITY OF BACOLOD ) S.S.


    x----------------------------x

    AFFIDAVIT OF NON-ACCEPTANCE

    I, JSUPT SAMSON P ABAYGAR (Ret), of Legal Age, Filipino, Married


    and resident of Blk. 2 Lot 18 Hermilinda Homes Mansilingan Bacolod City,
    Philippines, After having been duly swore to in accordance with law, do
    hereby depose and say;

    1. That I am already a BJMP Retiree, having retired (Optional


    Retirement) from the Bureau of Jail Management and Penology effective 01
    May 2013;

    2. That I am a bonafide member of the Armed Forces and Police Mutual


    Benefit Association Incorporated (AFPMBAI);

    3. That I have not received my policy contract from the AFPMBAI since
    my membership up to the present date;

    4. That I am executing this Affidavit of Non-Acceptance of my AFPMBAI


    Policy Contract to support the processing of my TERMINAL BENEFIT and CASH
    SURRENDER VALUE claims from the AFPMBAI;

    5. As such, I am executing this affidavit to attest the truthfulness of the


    foregoing facts;

    IN WITNESS WHEREOF, I have hereunto set my hand this ____Day


    of March 2017 in Makati City, Metro Manila, Philippines.

    JSUPT SAMSON P ABAYGAR


    Affiant

    TIN No. 132-937-015

    SUBCRIBED AND SWORN TO before me this ________ in Bacolod


    City, Philippines.

    Doc. No. _____;


    Page No._____;
    Book No._____;
    Series of _____;

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