REPUBLIC OF THE PHILIPPINES)

CITY OF ORMOC ) S.S.

AFFIDAVIT

I, PEPITO G. AVENIDO, Filipino, of legal age, married and a resident of District 13,
Ormoc City, Leyte, Philippines having been duly sworn in accordance with the law, hereby
depose and state THAT;

1. I am a retired PASAR employee with good moral character with length of service of
twenty-five (25) years;

2. I formally rendered my retirement sometime on September 2014;

3. I am applying for farm equipment loan at the office of Land Bank of the Philippine
Ormoc City Branch;

4. I hereby declare under oath that I have no existing loan to any bank, cooperative or
into other person herein;

5. I am executing this affidavit to attest the veracity of the foregoing facts and to support
for my application for farm equipment loan of the abovementioned bank and for
whatever purpose this may serve best.

Affiant further sayeth naught

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of _____

in Ormoc City, Philippines.

PEPITO G. AVENIDO
Affiant
OSCA-17255

SUBSCRIBED AND SWORN TO before me this __ of ______ at Ormoc City,

Philippines.