Republic of the Philippines )

City of Baguio ) S. S.
x--------------------------------x

AFFIDAVIT TAX EXEMPTION/

NON-FILING OF INCOME TAX RETURN

THAT I, ________________, of legal age, Filipino, single, and a resident of

__________________________, after having been sworn to in accordance with law,
hereby depose and state:

1. That I am the guardian of my minor sibling ____________;

2. That my sister is currently enrolled and attending as a Grade 7

student at the _____________________;

3. That my sister had been granted with a government

scholarship under the EDUCATION SERVICE CONTRACTING (ESC)
GRANT/SCHOLARSHIP APPLICATION;

4. That I am still a student and dependent upon the remittance

being sent by our parents, ____________________, both Overseas
Filipino Workers in ___________________;

5. That I have not filed my income tax return with the Bureau of
Internal Revenue because I do not have any gainful income on my
own and thus exempted under Republic Act 10963;

6. That I am executing this affidavit to attest to the facts and

circumstances why the affiant did not file an income tax return and in
order to attend to attest to the truthfulness of the above narration of
facts for all legal intents and purposes it might serve.

IN WITNESS WHEREOF, I have hereunto affixed our signature this 15 th day of

September 2020 at Baguio City, Philippines.

____________________
Affiant
ID: _____________

SUBSCRIBED AND SWORN to before me this 15th day of September 2020 at

Baguio City, Philippines.

Doc. No. _____;

Page No. _____;
Book No. ____;
Series of 2020.