REPUBLIC OF THE PHILIPPINES) QUEZON CITY, METRO MANILA) S.

AFFIDAVIT OF EXEMPTION OF INCOME TAX RETURNS

That I, [name], of legal age, Filipino, married to [spouse], with residence and postal address at [address], after having been duly sworn to in accordance with law hereby depose and state:

[reason for getting exemption]

That under Section 44 (2A) of the National Internal Revenue Code of the Philippines, as amended, affiant is exempted and not required to file any income tax returns as his/her gross annual compesation is only [amount] which does not exceed her personal and additional exemptions of P80,000.00;

That s/he did not file his/her income tax returns for the year involved in accordance with the provisions of the National Internal Revenue Code of the Philippines, as amended;

That this affidavit is executed in order to attest to the facts and circumstances why affiant did not file an income tax return for the year involved and in order to attest to the truthfulness of the above narration of facts for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___day of [month, year], at Quezon City, Metro Manila, Philippines.

__________________________ (Affiant)

SUBSCRIBED AND SWORN to before me this ___ day of [month, year], in Quezon City, Metro Manila, affiant exhibited to me his/her Resident Certificate No. ____________________ issued at ____________________, issued on ____________________.

Doc. No. _______ Page No. _______ Book No. _______ Series of _______