Republic of the Philippines)

City of Roxas ) s.s.

AFFIDAVIT OF DENIAL

I, ELIZABETH F. DELA CRUZ, of legal age, married, Filipino, and

presently residing at Lawis, Baybay, Roxas City, Philippines, under oath,
depose and say:

1. The Office of the Clerk of Court, Regional Trial Court, Roxas City,
has advised me that said Office could not issue the required Court
Clearance in view of the appearance of a name similar to my name in
their files involving a case filed against said person bearing name
similar to mine;

2. I am NOT the same person as one, ELIZABETH DELA CRUZ, who

was charged under Criminal Case No. 1980 before the Regional Trial
Court, Branch 18, Roxas City, for the crime of Violation of Batas
Pambansa Bilang 22 which was filed on January 14, 1985;

3. On January 14, 1985, I was still carrying my maiden name as

Elizabeth Fayo Fajader and I just carried my married name as Eliza
F. Dela Cruz after I got married on June 20, 1997. A copy of my
Certificate of Marriage is attached as Annex “A”;

4. I am executing this Affidavit to attest to the foregoing facts and to

deny categorically and specifically under oath that I am not the
same person who is an accused in the above-mentioned case and in
view of the foregoing, I am requesting the Office of the Clerk of
Court, Regional Trial Court of Roxas City to issue the appropriate
Court Clearance in my favor.

IN WITNESS WHEREOF, I have hereunto affixed my signature on this

7th day of February, 2019 at Roxas City, Philippines.

ELIZABETH F. DELA CRUZ

Affiant
UMID CRN-006-0106-6324-5

SUBSCRIBED AND SWORN to before me this ________________, at Roxas

City, Philippines. Affiant having exhibited to me her Identification Card No. as
stated above.

___________________________