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Republic of the Philippines )

City of ​XXXX )S.c.

AFFIDAVIT

I, ​NAME​, of legal age, married, Filipino, and a resident of___________,____________,


Philippines, after having been duly sworn in accordance with the law, hereby depose and state that:

1. I was duly accredited as Materials Engineer ​I/II by the Department of Public Works and
Highways on ​Date​ with Accreditation no. ​XXXX​.

2. I am not connected with or employed by any government office.

3. I am executing this Affidavit to attest to the truth of the foregoing and for all legal intents
and purpose it may serve.

IN WITNESS WHEREOF​, I have hereunto set my hand this ​XXth


​ day of ​Month Year at ​XXXX​,
Philippines.

​NAME
Affiant
PRC License no. ​XXXXXXX

SUBSCRIBED AND SWORN to before me this __​th day of ______, ____ at _____, Philippines by
the affiant who personally appeared before me and presented to me his PRC License indicated above,
which sufficiently establishes his identity, and who attests to the truth of the foregoing.

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