REPUBLIC OF THE PHILIPPINES )

CITY OF CAGAYAN DE ORO ) S.S.

AFFIDAVIT

I, IRISH E. DE JESUS, Filipino, 23 years old, married, and a resident of Zone 4

Upper Bulua, Cagayan de Oro City, after having been sworn to an oath in accordance
with law, do hereby depose and say:

1. That I am filing for application of waters services through Cagayan de Oro

Water District and the said application is under account number 203A-12-
0438/107460 previously under the name JULIET A. DE JESUS;

2. That however, there is an outstanding payable balance of Php4122.09 as it

was not paid where Php622.90 is already paid before the execution of this
affidavit;

3. That I undertake to pay said balance of Php3500.00, the amount will be

forwarded of transferred to my new account which I am currently applying for
the COWD at P200.00 per month until fully paid;

4. That the said transfer is necessary for the installation of water services and
because the above mentioned previous owner could no longer pay the same;
and

5. That I execute this affidavit to attest the truth of all my foregoing statements
and for whatever purpose it may serve;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 19 th day of

July, 2019, in Cagayan de Oro City, Philippines.

IRISH E. DE JESUS
Affiant

SUBSCRIBED AND SWORN to before me this 19th day of July, 2019, in Cagayan
de Oro City, Philippines.