REPUBLIC OF THE PHILIPPINES]

MALOLOS CITY, BULACAN ]S.S.

AFFIDAVIT OF INDIGENCY
I, PLACIDO RICARDO P. DE LEON III, Filipino, of
legal age, with residence and postal address at Km. 17
McArthur Hiway, Bancal, Meycauyan City, Bulacan, after
having been duly sworn to in accordance with law,
depose and states, that:

1.I am the husband of deceased Imelda S. De Leon;

2.We belong to the lower strata in life having no

sufficient source of income;

3.My gross income and that of my immediate family

do not exceed an amount double the monthly
minimum wage of an employee and that we do not
own real property as could be gleaned from the
attached certification from the Assessor’s Office
of Meycauayan City (please see Annex “C”- Ex-
parte Motion to litigate as Pauper);

4.Attached thereto also are the Certification of

Indigency issued by the Barangay concerned as
well as the Office of the Department of Social
Welfare and Development (DSWD); (Please see
Annexes “A” & “B”- Ex-parte Motion to litigate as
Pauper);

I am executing this affidavit to attest to the

truth of the foregoing and for whatever purpose it may
serve.

PLACIDO RICARDO P.DE LEON III

Affiant

SUBSCRIBED AND SWORN to before me this 27th day of

June 2013 at Malolos City, Bulacan. Affiant exhibited
to me his Postal ID No. 9842462 valid up to August
2013.

ROMEO B. CRUZ, JR.

Notary Public
Doc. No.____ UNTIL DEC. 31, 2013
Page No.____ PTR NO._____________
Book No.____ Malolos City,_______
Series of 2013