Republic of the Philippines )

CAMILING, TARLAC ) S.S.

AFFIDAVIT

I, ________________, ___ years old,

single/married/widower/widow, Filipino citizen, and a resident of
Barangay _____________, ___________, ___________, Philippines,
after having been duly sworn to in accordance with law, do hereby
depose and state THAT:

1. I have been a farmer for many years;

2. To this date, I have no outstanding loan or existing loan with

any bank or formal lending institutions;

3. I am executing this Affidavit to inform the Landbank of the

Philippines that I have no loan with any bank or lending
institutions and to support my application with its ACEF Lending
Program;

4. Finally, I am executing this Affidavit to attest to the truth of the

foregoing statements and for all legal intents and purposes it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____

day of ___________, 2019, at Camiling, Tarlac, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN to before me on the date and place

as above-stated. Affiant exhibited before me his/her
_________________________________________________________.

Doc. No.: _________;

Page No.: _________;
Book No.: _________;
Series of 2019.