REPUBLIC OF THE PHILIPPINES )

PROVINCE OF ______________ )S.S.

MUNICIPALITY OF _______ )
x---------------------------------------------------x

AFFIDAVIT OF INCOME

I, __________________, of legal age, married, Filipino citizen and with

residence and postal address at _______________________________, Camarines
Norte, after having been duly sworn to in accordance with law, hereby depose and
say:

1. That on May 5, 2014, I put up a variety store and piggery with 14 piglets at
Barangay Tamisan, Jose Panganiban, Camarines Norte;

2. That I am now earning an income from my variety store while I could earn
income from my piggery only after four (4) months of operations;

3. That I executed this affidavit in good faith for the information of all
concerned offices and for whatever legal purpose it may serve;

4. That all the statements above are true and correct to the best of my
knowledge and belief.

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day of May 2018 at
_________________________.

_______________________
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of May 2018 at

_____________________ affiant exhibited to me his LBC ID #_______________.

Doc. No._________;
Page No._________;
Book No._________;
Series of 2 0 1 8 .