Republic of the Philippines)

Province of Sarangani )
Municipality of Alabel ) s.s

AFFIDAVIT TO DEDUCT ALL FINANCIAL OBLIGATIONS

I, LOURDES A. LABAJO, of legal age, Filipino, married and a resident of Barangay
Lago, Glan, Sarangani Province, after having been sworn to in accordance with law, do
hereby depose and say that:

1. I am employed as Administrative Assistant III at Glan Medicare Community

Hospital, Glan, Sarangani Province;

2. I have filed my terminal fee in the government service;

3. All financial obligations that may be due to the different agencies of the Provincial
Government of Sarangani shall be charged from all the retirement benefits I may
acquire/obtain; and

4. I am executing this Affidavit to attest to the truthfulness and veracity of the

foregoing statements and to inform the proper authorities concerned to the
matter, and for such other legal purpose/s this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this _______________ at Alabel,

Sarangani Province.

LOURDES A. LABAJO
Affiant

SUBSCRIBED AND SWORN to before me this ________________, Affiant exhibiting to

me her valid ID No. _____________ as competent proof of her identity.

Doc. No.: ______

Page No.: ______
Book No.: ______
Series of 2020.