REPUBLIC OF THE PHILIPPINES )

Pagadian City, Zamboanga del Sur ) S.c.

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AFFIDAVIT
(RE: First-Time Job Seekers)

I, ________________________________, ___ years old, Filipino citizen, single /

married, and a bonafide resident of _________________________________________,
after having been duly sworn to an oath, depose and say, THAT:

1. I am a first-time job seeker / applicant;

2. I have been residing in my aforesaid address since ____________________;

3. I want to avail of the benefits of Republic Act No. 11261 otherwise known as
“The First-Time Job Seekers Assistance Act” which provides for the waiver of
fees and charges for first-time job seekers who are requesting for documents
such as licenses, proofs of identification, clearances, certificates, and other
papers required for employment whether locally or abroad issued by
government agencies including government owned and controlled
corporations (GOCCs), local government units (LGUs), and government
hospitals; and

4. I am executing this affidavit freely and voluntarily as my honest declaration of

the foregoing narration of facts for whatever legal purpose this may serve me
best.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of

_______________, 2020 in Pagadian City, Zamboanga del Sur, Philippines.

__________________________
Affiant
Government Issued ID & No. ___________________________
Issued by: _________________________________________
Valid Until: _________________________________________

SUBSCRIBED AND SWORN to before me this ____ day of ____________, 2020

at Pagadian City, Zamboanga del Sur, Philippines. Affiant personally appeared and
exhibited to me his/her competent evidence of identity as appearing below his/her name
and signature.