REPUBLIC OF THE PHILIPPINES)

City of Naga )S.S

AFFIDAVIT
I, BAMBIE F. TIPONES-BALBASTRE, Filipino, of legal age, married, and with
residence address at Gumamela St., Monte Cielo Centro Subd., Concepcion Grande,
Naga City, after having been duly sworn in accordance with law, do hereby depose and
say that:

1. That I am fit to work subject to the submission of my Latest Medical

Certificate (CSC Form No. 211, Revised 2017) with attached original copy of
the pertinent laboratory results.

2. I am fit to work as Clerk III of the Regional Trial Court – Office of the Clerk of
Court-Naga City;

3. This Affidavit is being executed in order to attest to the truth of the foregoing
facts and not for the purpose of fraud, but in connection with my application
as Clerk III of the Regional Trial Court – Office of the Clerk of Court-Naga City

IN WITNESS WHEREOF, I hereunto set my hand this 1st day of September,

2022 at Naga City, Philippines.

BAMBIE F. TIPONES-BALBASTRE
Affiant

SUBSCRIBED AND SWORN TO before me this September 1, 2022 at Naga

City, Camarines Sur, affiant exhibiting her Driver’s License with ID Nos. E04-20-002537,
bearing her name and signature, and valid until November 26, 2024.

Doc No. _________

Page No. _________
Book No. _________
Series of 2022.