REPUBLIC OF THE PHILIPPINES)

CITY OF Pasay )S.S

AFFIDAVIT OF NO EARNINGS

I, _____________________, 60 years old, married, Filipino, and a resident

of ______________________, after having been sworn in accordance with law, hereby
depose and state that:

1. Since June 1, 1995 when my family and I transferred our residence to the
above mentioned address until present, I was not hired nor employed by any company,
employer or otherwise.

2. That I was and still am dependent on my children for support and my basic
necessities.

3. That I am executing this affidavit to attest to the truth of the foregoing

statements and for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___th day

of September 2014 at the City of Pasay.

__________________________

Affiant

SUBSCRIBED AND SWORN to before me this 11th day of September 2014 at

City of Pasay, affiant exhibiting to me her SSS No. ________________.

Doc. No. ___

Page No.___
Book No.___
Series of 2014.