REPUBLIC OF THE PHILIPPINES)

PROVINCE OF _____________ : S.S.

MUNICIPALITY OF _____________ )

AFFIDAVIT OF NON-EMPLOYMENT

I, _____________, of legal age, Filipino, married to _____________, with

residence and postal address at _____________, Philippines, after having been
duly sworn to in accordance with law, do hereby depose and say:

THAT—

1. I am not presently employed in any capacity and not under any

affirmative obligation to obtain employment;

2. I am executing this Affidavit of Non-Employment to attest to the

truth of all the foregoing;

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_____________ at _____________, Philippines.

_____________
Affiant
ID No. _____________

SUBSCRIBED AND SWORN to before me this _____________ at

_____________,, Philippines, affiant exhibited to me her positive identification
duly noted above below her name and signature, known to me and to me
known to be the same person who executed foregoing instrument and
acknowledged to me that the same is her free act and deed and that she
voluntary executed the same and understood all the contents thereof.

WITNESS MY HAND AND SEAL.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 20___.