Republic of the Philippines )

_____________________ ) s.s.

AFFIDAVIT OF DENIAL

I, ______________, of legal age, Filipino and a resident of

____________________ , Quezon City, after having been sworn to the law, hereby
depose and depose and say:

1. That I’m the ________________________.

2. That relative to ________ renewal of its credit line with the ____________
of the Philippines, an adverse findings appeared concerning the name of a
certain _______________ as follows:

Adversely Classified Loan File

Financing Date Amount Date/ Other
Institution Reported Adverse Information

3. That, I vehemently deny to be the same person as the name appearing in the
abovementioned adverse findings from the ____________________ and the
_____________________;
4. That, based from my personal knowledge, I had never opened any bank
account, nor I had engaged in any transactions with the
_____________________;
5. That, I have never taken out any loan of such amount, as the amount
indicated above from the _____________________;
6. That, I do not know any person bearing the named “______________”;
7. That I have never been to _____________nor in any parts of ____________;
8. That, I am executing this affidavit to attest to the foregoing facts and to deny
categorically and specifically under oath that I am not the same person
disclosed in ________________________ records with adverse information.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ of February

2023 in ____________________.

Affiant

SUBSCRIBED AND SWORN to before me on this ___ day of _____________

2023 at ________________, affiant exhibited to me her competent evidence of
identity consisting of _________________________________.
 

NOTARY PUBLIC 

1
 Doc. No.  _____; 
Page No. _____; 
Book No. _____ 
Series of 2023.