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Republic of the Philippines )

Province of Laguna ) Sc.


City of Cabuyao )

AFFIDAVIT OF SALARY ASSIGNMENT


I, ANASTACIO MANGABAT MOTAS, JR., of legal age, married, member of the
Philippine National Police with the rank of Police Officer 2 presently assigned at Bian
City Police Station, Bian City, Laguna, with residence and postal address at Brgy. San
Jose, Calamba City, Laguna, after having been duly sworn to in accordance with law
hereby depose and state, that:

1. I am married to MARGOT DE VERA MOTAS on June 26, 2010 in a marriage ceremony


held at Saint Polycarp Parish in Cabuyao, Laguna;

2. Out of our marriage, our only child whose name is John Anthony De Vera Motas was
born on March 19, 2012;

3. At present, I and my wife have separated in fact which separation my wife demands
support for our child;

4. I agree to support our child and hereby releases my ATM Card to my wife, MARGOT DE
VERA MOTAS containing my salary until August 31, 2016;

5. Considering that I have several loans from different mutual benefit companies, I agree
not to secure, obtain or contract another loan other than those already existing;

6. I hereby assign FORTY PERCENT (40%) of my monthly salary to my wife, MARGOT


DATANAGAN DE VERA commencing in September 2016;

7. I am also assigning to my wife FIFTY PERCENT (50%) of my mid-year/year-end


bonuses;

8. I agree of the foregoing salary assignment with the end in view of terminating or
concluding any other financial obligation arising from my wifes demand for support;

9. I attest to the truthfulness of the foregoing facts and that no force, intimidation or
coercion was exerted upon my person.

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


December 2013 at Cabuyao City, Laguna.

ANASTACIO M. MOTAS JR.


Affiant

SUBSCRIBED AND SWORN to before me this ________________ at Cabuyao


City, Laguna. Affiant exhibited to me his __________________________ as competent
evidence of his identity.

________________________
Notary Public

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