AFFIDAVIT
I, ______________________________, Filipino citizen, of legal age, married to
____________________________, and a resident of ________________________________________,
after having been duly sworn in accordance with law, hereby depose and say:
1. _________________________________________________________
_________________________________________________________
_________________________________________________________
2. _________________________________________________________
_________________________________________________________
_________________________________________________________
3. _________________________________________________________
_________________________________________________________
_________________________________________________________
Further Affiant sayeth none.
IN WITNESS WHEREOF, I have hereunto affixed my signature this _____ day of __________,
20__ in ____________________ Philippines.
__________________________________
(Signature of Affiant over Printed Name)
SUBSCRIBED AND SWORN before me this _____ day of __________ 20__, by
____________________ who exhibited to me his CTC No. ____________________ issued on
_______________ at ___________________.
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20 ___.