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Republic of the Philippines )

City of Cebu…………………….)
Cebu…………………….) S.S.

AFFIDAVIT OF NON-FILING OF INCOME TAX RETURN

I, RICARDO S. DALISAY, of legal age, Filipino, married, and a resident of Sitio


Mangga Punta Princesa, Cebu City, Philippines haing been duly s!orn in accordance
!ith la!, hereby depose and state"

#. $hat
$hat I am the biolo
biologic
gical
al fa
fathe
therr of RICARDO A. DALISAY, JR.%

&. $hat RICARDO A. DALISAY, JR.% is currently enrolled as 'rade #( student


at niersity of San *ose+Recoletos
*ose+Recoletos asa- Campus%

. $hat
$hat my son is applyin
applying
g in a Scholar
Scholarshi
ship
p Program
Program under
under the Senior
Senior /igh
/igh
School 0oucher Program for S1 &(#2+&(#3%

4. $hat
$hat one of the re5uir
re5uirem
ement
entss is a proof
proof of the ureau
ureau of Int
Intern
ernal
al Reenue
Reenue
6IR) alidated Income $a7 Return 6I$R) of parents%

8. $hat
$hat I did
did no
nott file
file my I$R in the IR becau
because
se my annual
annual incom
incomee does not
not
e7ceed si7ty thousand pesos 6Php. 9(,(((.(() my :ob being a :eepney drier
!here my sales income are usually fluctuating%

9. $hat
$hat I am e7ecut
e7ecuting
ing this
this affidai
affidaitt to attest
attest to the eracit
eracity
y of the forego
foregoing
ing
facts, in support of my son;s application for scholarship and for !hateer
legal purpose this may sere.

IN WITNESS WHEREOF, I hae hereunto affi7ed my signature this 8 th day of


February &(#2, in Cebu City, Philippines.

RICARDO S. DALISAY
  <ffiant
SSS I=. >o. #(#934(8#3(
Issued at" Cebu City

SUBSCRIBED AND SWORN to before me this 8 th day of February &(#2 at Cebu


City, Philippines. <ffiant e7hibited
e7hibited to me his competent eidence of identity as per data
indicated belo! his name.

=oc. >o. ___ %
Page >o. ???%
oo- >o. ???%
Series of 2017.

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