Republic of the Philippines )

Province of Bulacan ) s.s.

Municipality of Baliwag)
AFFIDAVIT OF LOW INCOME

I, GIO MIGUEL M. ONG, of legal age, Filipino, and a resident of Lot 21, Blk 7, Lilac St.,
Milflora Homes, Sabang, Baliuag City, Bulacan, after having been sworn in accordance with law, do
hereby depose and say:

1. That I studied at Fernandez College of Arts and Technology (FCAT) located at Gil Carlos
St., Poblacion, Baliuag City, Bulacan with the course of Bachelor of Science in Hotel and
Restaurant Management (BSHRM) for the School Years
________________________________ ;

2. That I did not finish the 4 year degree course on BSHRMN at FCAT being an
undergraduate ;

3. That I requested for my Transcript of Records for my BSHRM course with the FCAT
Registrar but my request was promptly denied ;

4. That the reason for such denial is that I still have an outstanding balance with FCAT for
my studies as a BSHRM student in the amount of
_____________________________________________ PESOS (P
______________________ ) ;

5. That I earn ___________________________________________PESOS (P _________ )

a month as such household helper ;

6. That as proof of such balance, a copy of such certification attested to by the Accounting
Department of FCAT is hereto attached ;

7. That I am executing this to attest to the truthfulness of the above-mentioned facts ;

8. That I am executing this affidavit to attest to the fact that I studied BSHRM at FCAT for
the School Years above-mentioned ;

9. That I am also executing this affidavit to attest that my request for my TOR was denied or
disapproved by the FCAT Registrar because of my outstanding balance ;

10. That I am also executing this affidavit for any purpose/s allowed by the law ;

IN WITNESS WHEREOF, I have hereunto set my hand this March 6, 2023, at the
Municipality of Baliwag, Province of Bulacan.

GIO MIGUEL M. ONG

Affiant

SUBSCRIBED AND SWORN to before me this March 6, 2023 at the Municipality of

Baliwag, Province of Bulacan, affiant showing to me his ID.
 ATTY. CRISTOBAL R. FERNANDEZ
IV
NOTARY PUBLIC
Until December 31, 2023
PTR No. 0389967/ January 3, 2023
IBP OR No. 257680 / January 3, 2022
MCLE NO. VII 0020095 / June 1, 2022
Doc. No. __________ ; Roll No. 57387
Page No. __________ ;
Book No. __________ ;
Series of 2023 .