Republic of the Philippines) S.S.

City of Zamboanga)
x------------x
AFFIDAVIT

I, LIEZELMAE E. DELA CRUZ, Filipino, of legal age, single and a resident of

Marsolo, Naga, Zamboanga Sibugay, Philippines, after being sworn to in
accordance with law, depose and state:
That per Certification dated March 28, 2017 issued by HERMINIO O. SALE,
M.D., FPAMS Medical Director of Danao-Sale Hospital, Crossing Sta. Clara,
Naga, Zamboanga Sibugay, I am employed as STAFF NURSE, from April 16,
2013 up to the present date under General Nursing Services.
That I am executing this Affidavit to attest to the truth of the forgoing and
for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 9 th day of September
2019 in Zamboanga City, Philippines.

LIEZELMAE E. DELA CRUZ

AFFIANT

SUBSCRIBED AND SWORN to before me this 9th day of September 2019 at

Zamboanga City, Philippines. Affiant exhibited to me as his valid proof of identity,
PRC License bearing No. 0802773, issued at Zamboanga City, and valid until 14
April 2022.

Doc. No. 435; JOHN JASON N. ALBRECHT

Page No. 88; NOTARY PUBLIC
RD
Book No. 01; 3 Level, Edificio Coastal
Series of 2019; Corcuera Street, Zamboanga City
P.T.R No. 1830104, 08 Jan. 2019, Z.C
Roll of Attorney’s No. 67102
I.B.P O.R No. 069245, 15 Jan. 2019, ZC
Notarial Commission No. 40-2019