REPUBLIC OF THE PHILIPPINES )

. . . . . . . . . ) S.S.
x - - - - - - - -- - - -- - - -- - - -- - - - x

A F F I D A V I T

I, JULIET S. PORTUGUES, of legal age, married and a resident of 08 Brgy. Victoria,

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

RE: CITIZENSHIP

That I am the Proprietress of AMIANAN CONSTRUCTION with business address at

08 Brgy. Victoria, Alicia, Isabela;

That I am a FILIPINO CITIZEN having been born on October 1, 1954 in QUIRINO,

ISABELA;

That i am executing this affidavit to attest to the truth of the foregoing facts, to inform the
proper authorities concerned and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this_____________ at

_______________.

JULIET S. PORTUGUES
Affiant

SUBSCRIBED AND SWORN to before me, a Notary Public for and in the
____________________, this ___________________ affiant exhibited to me her TIN 140-428-
652.

Doc. No.
Page No.
Book No.
Series of 2015