AFFIDAVIT OF NON-DEDUCTION

I, ___________________, Filipino, of legal age, and a resident of __________________________after having

been duly sworn in accordance with law, hereby depose and say:

1. That I am the President of _______________duly organized and existing under the laws of the
Philippines with registered address at ___________________________________________
2. That the said Corporation was incorporated on _______________ with SEC No. ____________
3. That the said Corporation has not commenced its operations from _______________up to
_________________That the said Corporation did not deduct an employee contribution for Home
Development Mutual Fund (HDMF) from ________________ to _________________
4. That this affidavit is being executed in order to attest to the truth of the foregoing circumstances and
for the purpose of complying with Home Development Mutual Fund.

WITNESS WHEREOF, I have hereunto affixed my signature this _________day of ________________ at

_________________ Philippines

_____________________________
Affiant

REPUBLIC OF THE PHILIPPINES)

_______________________) SS.

SUBSCRIBED AND SWORN TO before me, a notary public in and for ____________ this ____day of
_________________2019. The affiant, whom I identified through the following competent evidence of identity:
TIN# ______________ issued by Bureau of Internal Revenue, personally signed the foregoing instrument before
me and avowed under penalty of the law to the whole truth of the contents of said instrument.

Doc. No._____
Page No. ____
Book No. ____
Series of 2019