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(Affidavit of Compliance with BFAD Requirements on the Use of Certain Food Chemicals)

REPUBLIC OF THE PHILIPPINES) Province of ____________________) S.S. City/Municipality of _____________) x-----------------------x AFFIDAVIT

I, RAMON Ll. SEMSEM, Filipino, of legal age, married, and a resident of Espartinez Subd., Baumbayan, Daraga, Albay, after being duly sworn in accordance Mth law, depose and state:
1 That I am the Computer operator of NEYCARL INTERNET CAFE;

That the said company has been operating the business since Nov. 2010, that due to low income I decided to vacate my position as Computer operator to look for a Greener Pasture;

3 4 That since July 1, 2010, I am already separated to NEYCARD INTERNET CAFE;

That I am executing this Affidavit to attest the truth of the foregoing and for whatever other legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at _____________, Philippines.

AFFIANT

(JURAT)

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