You are on page 1of 1

REPUBLIC OF THE PHILIPPINES )

CITY OF )

JOINT AFFIDAVIT

We, Enrique G. Yao and Marylene Fajardo Odtohan of legal ages, Filipino and Filipino,
single and married and residing at 2181 Paraiso Dasmarinas Village Makati City and
107 H. Javier St. Santulan Malabon City, and employed as Chairmain and Office Staff
respectively, by Leo Tire Manufacturing Corporation with business address at Room 501
APC Bldg., 1186 Quezon Avenue, Paligsahan, Quezon City and plant addess at 88
Rubber Master Road, Lingunan, Valenzuela City after having been duly sworn in
accordance with the law, do hereby depose and say:

That, Leo Tire Manufacturing Corporation is a renewal applicant for a PDEA License to
handle the following specified controlled chemicals and/or its mixtures:

Name of Controlled Purpose of Annual Projected


Chemicals Handling Quantity Supplier/s
and/or its Mixtures

95-100% Toluene Used as solvent 25,000 Liters Trademore Chem.,


for adhesive Inc.

That, the above cited controlled chemicals and/or its mixtures hall be solely used for the
legitimate purpose governing the nature of the applicants legitimate existence, and in
no case will it be diverted to illegal purposes.

That, for and in behalf of our establishment and by virtue of this Affidavit, we hereby
bind ourselves to all the provisions of Republic Act 9165 otherwise known as the
Comprehensive Dangerous Drugs Act of 2002, and its implementing Rules and
Regulations and assuring that such law and regulations shall be faithfully complied with;

That, we are executing this Affidavit to attest the truth of the foregoing facts, and for
whatever legal intent and purpose it may serve.

IN WITNESS HEREOF, we have hereunto set our hands this _____________day of


__________________, 20______ at ______________________________________,
Philippines.

ENRIQUE G. YAO MARYLENE FAJARDO ODTOHAN


Chairman Office Staff

SUBSCRIBED AND SWORN to before me this ___________day of


__________________________________, 20____at __________________________,
Philippines.

Affiants personally exhibiting their Community Tax Certificate Nos. CCI2015 33221469
and TIN ID No. 157-495-988 issued on 01/19/2017 and 01/13/02010 at Valenzuela City
and Quezon City, respectively.

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