Republic of the Philippines)

Imus, Cavite ) s.s.

AFFIDAVIT OF NON-FILING OF ITR

WE, Spouses __________________ and __________________, both of legal age,

Filipinos, with postal address at _______________________________, after having been sworn
to in accordance with law, hereby depose and say:

1. That we are the parents of _____________________, ______years old and attending

school at the _________________;

2. We used to have a _____________________ from the year ______ to ________, but

the owner terminated our contract;

3. We hereby attest to the fact that we are now both unemployed and having no other
business from which we can derive any income;

4. That we merely rely on the support given to us by our children;

5. Because of the above, both of us do not file any Income Tax Return.

IN WITNESS WHEREOF, we hereunto affix our signature this __ day of __________ 2015.

__________________ _________________
Affiant Affiant

SUBSCRIBED AND SWORN to before me this __ day of ___________ 2015, affiant

exhibited a competent proof of their Identity:
Govt. Issued I.D. Valid Until
__________________ _______________________ ________________
__________________ _______________________ ________________

Notary Public

Doc. No. __________;

Page No. __________;
Book No. __________;
Series of 2015.