REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO
) S.S.
x------------------------------------------x
AFFIDAVIT
I, NENITA D. TE, of legal age, Filipino, married and a resident of Brgy. Bakhaw, Mandurriao,
Iloilo City, after having been duly sworn to in accordance with law, hereby depose and state:
1. That I am a Dentist practicing my profession in the City of Manila prior to 2009;
2. That in 2009 because of the emotional stress in dealing with my problems about my
husband that eventually led me to file a case against him for violating RA 9262
( Anti-Violence against Women and their Children Act), I temporarily stopped
practicing my profession;
3. That in 2009 I transferred residence in Iloilo City;
4. That because of the said transfer, I could no longer locate my used and unused official
receipt booklets;
5. That despite of diligent search and effort, the same could no longer be found such that
I now believe that it is now lost beyond recovery
6. That I am executing this affidavit to attest to the foregoing and to support the
processing of the transfer of my home revenue district office from RDO 31 to RDO
74;
IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Iloilo
City, Philippines.

NENITA D. TE
Affiant
UMID 0111-3887835-2
SUBCRIBED AND SWORN TO before me this ___________________ in Iloilo
City, Philippines, affiant exhibiting to me her valid proof of identification.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2015.