SWORN DECLARATION

REPUBLIC OF THE PHILIPPINES

PROVINCE OF ________________
CITY/MUNICIPALITY OF ______________

I, Erlinda Dael, Filipino, of legal age, designated as Punong Barangay of Barangay Government
Unit- Barangay Pingan with business address located at Barangay Pingan Gen. MacArthur
Eastern Samar do hereby certify the following:

 That in compliance with the requirement of Revenue Regulations No.___, submitted

herewith is one (1) DVD-R containing twenty (20) scanned BIR Form 2307 covering the
period January 01, 2020 to December 31, 2020.
 That the contents of the DVD-R being submitted herewith conform to the Conditions or
specifications requirements set by the Bureau of Internal Revenue.
 That the soft copies of the BIR Form 2307 contained in the DVD-R being submitted
herewith are the complete and exact copies of the original thereof.

I HEREBY DECLARE UNDER THE PENALTIES OF PERJURY THAT THE

FOREGOING ATTESTATIONS ARE TRUE AND CORRECT.

__ Erlinda Dael
Name and Signature of
Authorized Representative

SUBSCRIBED and sworn to before me, in the City/Municipality of _______________,

this day of_____, 20___by _______________with Residence Certificate No.
_______________issued at ______________________, of ___________20____.

Notary public
Doc No.____________
Page No.____________
Book No.____________
Series of_____________