Republic of the Philippines )

City of ________________ ) S.S.

AFFIDAVIT OF LOW INCOME

I, GENEBETH M. BUSTRIA of legal age, Filipino, and a resident of Santol street purok
anahaw buhangin Davao City, Philippines, after having been duly sworn in accordance with law,
hereby depose and state:

1. That I am the same person executing this affidavit;

2. Tha I am the mother of Ma. Cristina M. Bustria who is a highschool graduate applying for
a CHED scholarship program;

3. That the annual income of our family does not exceed P30,000.00;

4. That the wage of my husband is so meager and enough only to cover our daily needs;

5. Finally, to attest the truthfulness of the foregoing statement and for all intent and legal
purposes it may be serve;

GENEBETH M. BUSTRIA
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this___________day of _______________ in

the City of _______________, affiant exhibiting to me his/her Tax Identification No./valid
identification __________________ issued at _________, Philippines.

Doc. No. _____;

Page No. _____;

Book No. _____;

Series of 2019.