Affidavit

REPUBLIC OF THE PHILIPPINES)
________ CITY                               ) SS.

AFFIDAVIT

I, ________________, Filipino, of legal age, with  address at __________________________________, after having been sworn to in accordance with law hereby depose and state that:
 1. ]

 2. ]    STATE THE FACTS!

 3.]

 4.   I herein attest to the truthfulness of the foregoing facts.
 

AFFIANT FURTHER SAYETH NAUGHT.

 IN WITNESS WHEREOF, I hereby affix my signature this ___ day of __________200__ in ___________ City.
 
  

                                                                                                                                    _______________________
                                                                                                                                                           Affiant
 

 SUBSCRIBED AND SWORN to before me, a Notary Public, this ___ day of  ____________ 200__ at _____________ City, affiant exhibited to me his Community Tax Certificate No. ____________ issued on ______________ at ______________.
 

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Series of 200_.