Republic of the Philippines )

Quezon City ) S.S.

AFFIDAVIT OF NON-PENDENCY OF ADMINISTRATIVE/CRIMINAL CASE

And NON-EMPLOYMENT

I, LEONY D. VELOSO of legal age, Filipino, with permanent address at 221 Bahay
Pare Sitio 3, Meycauayan, Bulacan, Philippines, after having been duly sworn to in accordance
with law, hereby voluntarily depose and say that:

1. I am the mother and legal guardian (hereinafter, Legal Guardian) of minor,

KIMBERLY GRACE DIAZ VELOSO, whose date/s of birth appeared as MAY
25, 2000, (hereinafter, the Minor) on her birth certificate attached hereto as
Annex A;

2. There is no other judicially appointed guardian over the person or property of the
Minor;

3. There is no pending administrative or criminal case filed against the Minor;

4. The Minor is not involved in any administrative or criminal case;

5. Further, as of the present time, the Minor is not employed in any capacity at any
corporation, company, and individual person;

6. That I am executing this affidavit to attest to the truth of the foregoing facts for
the expeditious processing of my retirement benefits.

IN WITNESS HEREOF, I have set my hand and affixed my signature this _____day of
_____________, 20______ at ___________.

(Affiant)

SUBSCRIBED AND SWORN TO BEFORE ME this _______ day of _________

___________, 20 ______, affiant exhibited to me his/her Government Issued ID
__________with No._________________ issued at ____________________ on
____________________.

Doc. No. ________

Page No. ________
Book No. ________
Series of ________ NOTARY PUBLIC