Republic of the Philippines ]

Province of Benguet ] s.c.

Municipality of La Trinidad ]

AFFIDAVIT OF EXPLANATION
Re: Non Claim of BIR TIN CARD
I, TRIXIE JAYE B. MONTALBAN, of legal age, Filipino, single, and a
resident Baguio City after having been duly sworn to in accordance with law, hereby
depose and state that:

1. I applied for a Taxpayer’s Identification Number (TIN) sometime last October

of 2018 at BIR – La Trinidad;

2. To date the Taxpayer’s Identification Number (TIN) CARD was not claimed
by me;

3. After applying for said TIN CARD, I failed to claim it because of my

inadvertence and that I totally forgot to claim it on time;

4. My non claim was only an inadvertence on my part and was not intentional
nor was it meant to deceive or defraud the government;

5. I am executing this affidavit to attest to the truth of the foregoing statements

of facts and for all legal intents and purposes this may well serve.

IN WITNESS WHEREOF, I hereunto set my hands this 20 th day of November,

2019 at La Trinidad, Benguet, Philippines.

TRIXIE JAYE B. MONTALBAN

Affiant
School ID 1500511

SUBSCRIBED AND SWORN TO BEFORE ME this 20th day of November,

2019 at La Trinidad, Benguet, the affiant exhibiting to me his/her competent proof of
identification indicated below his/her name and avowed under the penalty of law to
the truth of all the foregoing.

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Series of 2019