Republic of the Philippines )

: S.S.
Quezon City )

AFFIDAVIT

I, JUAN A. ORDOÑO JR., of legal age, a widower, Filipino, and with address at
75 Batino Street, Barangay Amihan, Project 3, Quezon City, after having been duly sworn in
accordance with law, hereby depose and state, THAT:

1. I have lived at my present address since 1968;

2. That as of the present time, I am not employed in any capacity at any corporation,
company, and individual person;

3. I am executing this affidavit to attest to the truth of the foregoing facts, and for
whatever legal purpose that this may serve.

IN WITNESS THEREOF, I have hereunto affix my signature this ______ day of

________________ 2020, at ___________________, Philippines.

JUAN A. ORDOÑO JR.

Affiant

SUBSCRIBE AND SWORN to before me this _____ day of ________________ 2020.

Doc. No. ______;

Page No. ______;
Book No. _____;
Series of 2020.