Republic of the Philippines)

City of Iloilo )S.S.

x-------------------------------x

AFFIDAVIT OF NO PENDING CASE

I, ABC, Filipino, of legal age, single, and a resident of 30th block 200 lot 555 Westwood
Subdivision Barangay Dungon C Mandurriao, Iloilo City, after having been duly sworn in
accordance with law, hereby depose and say that:

1. I was born and raised in Mandurriao Iloilo City;

2. I have no pending case, criminal, civil or administrative, before any judicial authorities or
agency in the government;

3. Attaching here in my record as a proof for no pending case, criminal, civil or administrative,
before any judicial authorities or agency in the government, Annex “A” for my municipal
clearance; Annex “B” RTC Clearance; Annex “C” NBI Clearance; Annex “D” Police
Clearance; Annex “E” Mayor Clearance; and Annex “F” Barangay Clearance.

4. I am neither an advocate nor a mentor of any unlawful or subversive organization that

advocate the overthrow of the government or agency in the government;

5. That said Identificatiom Card was not confiscated by the authorities or of philhealth by
reason of any violation of rules and regulations;

6. That I am executing this affidavit to attest to the truth of the foregoing facts and
circumstances, for the purpose to apply as a reservist Philippine Army and for whatever
legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 18th day of November
2023 at Manudurriao, Iloilo City, Philippines.

ABC
Affiant
PRC 12210
Issued by PRC
Valid until December 20,2023

SUBSCRIBED AND SWORN to before me, in Mandurriao, Iloilo City, Philippines this
18th day of November 2023. The affiant, whom I identified through competent evidence of
identity, stated below his name, personally signed the foregoing instrument before me and
avowed under penalty of law to the whole truth of the contents of this affidavit.

ATTY. JJJ M. PPP

Notary Public for and in the City and Province of Iloilo
My Commission No. is 123
Expires on May 31, 2024
PPP Law Office
Lopez Street, Mandurriao, Iloilo City
Roll of Attorneys No. 12345
IBP no. 1234567 Lifetime
Doc No. 000;
Page No. 00;
Book No. VIII.;
Series of 2023.