REPUBLIC OF THE PHILIPPINES )

CITY OF CAGAYAN DE ORO) S.S.

AFFIDAVIT OF NO PENDING
ADMINISTRATIVE/CRIMINAL CASE

I, RAE LYNNE DELA ROSA YPARRAGUIRRE, of legal age,

Filipino, single, with permanent address at #91 7th-21st Streets,
Nazareth, Cagayan de Oro City, after having been duly sworn to in
accordance with law, hereby voluntarily depose and say:

1. That I have no pending administrative and/or criminal

case before any court/authorized body;

2. That I have never been found guilty/convicted of any

administrative offense and/or crime;

3. That I am executing this affidavit in support of my

employment application with the Philippine Ports
Authority - PMO Misamis Oriental/Cagayan de Oro City;

4. That I understand that any misrepresentation as to the

truth of the foregoing shall cause the disapproval and/or
outright disqualification of my employment application
without prejudice to the filing of administrative and/or
criminal case/s against me;

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

the foregoing facts for the above-mentioned employment
application.

IN WITNESS HEREOF, I have set my hand and affixed my

signature this 3rd day of July 2020 at Cagayan de Oro City, Philippines.

RAE LYNNE DELA ROSA YPARRAGUIRRE

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this ___ day of

________, 20__, affiant exhibited to me his Government Issued ID
__________No.______________ issued at __________________ on
____________________.

NOTARY PUBLIC
Doc. No. ________
Page No. ________
Book No. ________
Series of ________