Republic of the Philippines)

______________________) SS.

SWORN STATEMENT

I, _____Name_____, Filipino, of legal age, married/single, and a resident of

_____complete address______, after having been duly sworn on oath in accordance with
law hereby voluntarily depose and say that:

1. I sent my application to the position as _____Position______ with

_____Employer/Company____ (Company based in Singapore) via
____email/mail/personal_____ in ____Date____.
2. I was chosen for the position applied, but will only be accepted provided that I
passed the following ____training requirements/requirement____ which only
being held in Singapore:
a. _________
b. _________
In order to comply with these requirements, I entered Singapore as tourist.
3. After passing these requirements, I processed all necessary employment
requirements with Singapore Ministry of Manpower and started the job after
granting the work permit.
4. This undertaking is being executed to attest to the veracity of the foregoing and
as requirement for the purpose of securing Overseas Employment Certificate
(OEC) with Philippine Overseas Employment Administration (POEA).

IN TRUTH WHEREOF, I have hereunto set my hand and affix my signature on

this _____ day of __Month__, __Year__, in ______________Place______________.

___________________________
Affiant

BEFORE ME, personally appeared ________________, with Philippine Passport

No. ______________, known to me to be the same person who executed the foregoing
instrument, and she acknowledged to me that the same is his free act and deed.

WITNESS MY HAND AND SEAL this ____ day of _Month_, _Year_in

_________________________.

Notary Public

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of _____.