REPUBLIC OF THE PHILIPPINES)

CITY OF BACOOR )S.S

AFFIDAVIT OF NO INCOME

I, JOCELYN L. SELORIO, of legal age, Filipino, single and a resident of

P2 B7 L10 Ecotrend Subd San Nicolas 1, Bacoor, Cavite after having been duly sworn
to in accordance with law, depose and state:

1. That I am the mother of JULIUS DANE L. SELORIO, born on October 19,

2006 and a Grade 9 student of St. Dominic College of Asia;

2. That one of the requirements for his application for scholarship in ESC is an
Income Tax Return (ITR) filed by the parent of the student;

3. That I am unemployed and a housewife with no source of income and due to

said reason, I am not filing an Income Tax Return at any Branch of Bureau
of Internal Revenue;

4. That I am further executing this Affidavit to attest the truth of the foregoing
facts and for the purpose of submitting this as a requirement for ESC
Application of son, Julius Dane L. Selorio.

IN WITNESS WHEREOF, we have hereunto set our hands

this ___________________ in _______________, Philippines.

JOCELYN L. SELORIO
Affiant

        
SUBCRIBED AND SWORN TO before me this ___________________ in
_________________, Philippines, affiants exhibiting to me their valid proofs of
identification.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.