SWORN STATEMENT

I, Calvin Klein , of legal age, currently residing at, San Pascual Camarines Norte, after
having been duly sworn in accordance of law, do hereby depose and state that:

1. I am Calvin Klein a non-resident Filipino citizen / Overseas Filipino

Workers(OFW) with proof of permission to work abroad as evidenced by my
Working Visa with number 798236475

2. My source of income is from outside the Philippines and I do not derive any
income from Philippine sources. As such, I am not required to file an
individual income tax return (ITR) in the Philippines

3. Likewise, I have never applied for and been issued TIN

4. I am executing this sworn statement to attest the truth of all the foregoing
statements and for whatever legal purposes it may serve

5. I undertake to immediately inform HSBC and submit the ITR annually in the
event that I have income earned from sources within the Philippines. My
failure to do so will be considered a breach of the terms and conditions of my
loan with HSBC

IN WITNESS THEREOF, I have hereunto set my hands this 3rd day of

November 2019

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Affiant (Affix signature above printed name)

Republic of the Philippines )

City of Naga ) S.S

SUBSCRIBED AND SWORN TO before me this 3rd day of November 2019

affiant exhibiting before me his/her Community Tax Certificate No. 7989 I.D. issued on
November 3 2019 and will expire on December 25 2020

Doc No.

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Series of 2019