REPUBLIC OF THE PHILIPPINES)
________________________) S.S.
AFFIDAVIT OF NON FILING
I, _______________________________________, of legal age, single/married, Filipino, and a
resident of _____________________________________________________________ after having been
duly sworn to in accordance with the law, hereby depose and say:
1. I do not have sufficient source of income/unemployed for _______;
2. That as a consequence I did not file my Income Tax Return for the past years;
3. That I am executing this affidavit, to attest to the truthfulness of the foregoing facts and for all legal
intents and purposes.
IN WITNESS WHEREOF, I have hereunto set my hands this ____ day of ________, 20___ at
___________________________.
___________________________
Affiant
CTC No. ____________________
Issued at ___________________
SUBSCRIBED AND SWORN to before me this ________ day of ____________, 20____ at
_____________________________, affiant exhibited to me her Community Tax Certificate as indicated
above.
Doc. No. ________;
Page. No. _______;
Book No. _______;
Series of _______;