Republic of the Philippines )

Cainta, Rizal ) S.S.

AFFIDAVIT

I, _______________ of legal age, Filipino, and resident of _______________after

having been duly sworn to in accordance with law, do hereby depose and say that:

1. That I am the holder of a CERTIFICATE OF EMPLOYMENT dated May 3, 2016 duly

issued by _______________

2. That I hereby declare that all the information appearing in the above described
document is true and correct and based on authentic records;

3. That I am executing this affidavit to attest to the truth of the foregoing fact and for
whatever legal purposes it may serve.

AFFIANT FURTHER SAYETH NAUGHT

_______________
Affiant

SUBSCRIBED AND SWORN TO before me on this 20 th day of May 2016 at Cainta, Rizal,
affiant exhibiting to me her Phil Health ID with I.D. number _______________bearing her
photo and signature as competent evidence of identity.

Doc. No. ;
Page No. ;
Book No. ;
Series of 2016.