REPUBLIC OF THE PHILIPPINES)

MANDAUE CITY )S.S.

AFFIDAVIT

KNOW ALL MEN BY THESE PRESENTS:

I, MARGARITO QUIMQUE MATCHICA, Filipino, of legal age, and a resident of

_____________________, after having been sworn to in accordance with law, do
hereby depose and say:

1. That I am the same affiant herein;

2. That I have an outstanding loan with the Social Security System (SSS), which
was incurred in the year 2018.

3. That I have resigned from my position in ANDORRA TILE ROOFINGS INC.

(attached herewith is a copy of my resignation letter dated August 13, 2019
and made an integral part of this document.)

4. That I hereby declare that ANDORRA TILE ROOFINGS INC. is not liable for
my outstanding obligation with the SSS.

5. That I am executing this affidavit to attest to the truthfulness and veracity of

the foregoing facts and for whatever legal purpose this document may serve.

IN WITNESS WHEREOF, I have hereunto signed this instrument in Mandaue

City, Philippines, this ___ day of __________ 2019.

MARGARITO QUIMQUE MATCHICA

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this ___ day of __________

2019, at Mandaue City affiant exhibited to me his ____________ ID bearing the
numbers ____________ valid until as competent evidence of his identity.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2019.