Republic of the Philippines)

City of Antipolo, Province of Rizal) S.S.

SWORN AFFIDAVIT

I, __________________, of legal age, single, and a resident of

_________________________City after having duly sworn to in accordance with law, do hereby
depose and state:
1. That, I have no relative within the third civil degree of consanguinity or affinity who is an
incumbent employee in the Office of the _________________________;
2. That, I am executing this Affidavit as one of the requirements in connection with my
application for the position ____________________________________
3. That, I am executing this affidavit to attest to the truth and veracity of the foregoing statements
and made for all legal intents and purposes.
IN WITNESS THEREOF, I have hereunto signed this affidavit on this 17th day of July
2020, here at Antipolo City.

Affiant

SUBSCRIBED AND SWORN to before me this 17th day JULY 2020 in Antipolo City,
Rizal, Affiant has exhibited to me her valid ID ______________________issued by
_____________.

NOTARY PUBLIC
Doc No.____________
Page No.___________
Book No.____________
Series 2020.__________