AFFIDAVIT

I, JORGE HERNANDEZ DISUANCO, Filipino, of legal age, with business address at

38 Champaca St. Merville Subd. Tanza, 1490, City of Navotas, NCR, Third District
Philippines, after having duly sworn to in accordance with the law do hereby depose and
state:

1. That, I am the Owner of JORGEM PRINTING, TIN Number 193-275-108-000, a

firm duly organized and existing under the virtue of laws of the Republic of the
Philippines and with office address at 38 Champaca St. Merville Subd. Tanza,
Navotas City;
2. That due to the error in Business address registration of the ELVIS BRIGOLE
LAGUSAN (Elvis B. Lagusan), TIN Number 729-057-627-002, JORGEM
PRINTING was not able to proceed with the printing of invoices for the Authority to
Printed stated below:

OCN: 039AU20230000010016
Date of ATP: November 23, 2023
Sales Invoice, 50x3, VAT, Bound, Serial Nos. 001-500
3. That, I am executing this affidavit to attest to the truth and veracity of foregoing facts
and circumstances and for whatever legal intent it may serve best.

AFFIANT SAYETH NAUGHT.

JORGE HERNANDEZ DISUANCO

Owner

SUBSCRIBED and SWORN to before me, this ______ day of __________, 2021 in _______
City, Philippines.

Doc. No.:
Page No.:
Book No.:
Series of 2023