Republic of the Philippines )

Batangas City
) S.S
x----------------------------------x
AFFIDAVIT
I, _____________________ , of legal age, Filipino citizen, ___________ and
resident of _____________________________, Philippines after having been duly
sworn to in accordance with the law do hereby depose and state:
That I worked as _____________at the ________________from __________ to
______________. A certification was issued to me on _____day of ____________
2016
at
___________________________________to
attest
the
foregoing
information. ( Attached hereto is the certified true copy of the said
certification as ANNEX A).
That I am executing this affidavit to affirm the truth of the foregoing
and for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto signed this affidavit this ____day of
____, 2016 in _______, Philippines.
Affiant

SUBSCRIBED AND SWORN to before me this _____________at____________,

Philippines affiant exhibiting to me his competent evidence of identity:
______________
Notary Public