Republic of the Philippines….

}
Municipality of Don Carlos..…. }S.s
Province of Bukidnon…… }
X-----------------------------------------------/

AFFIDAVIT OF NO PENDING CASE

I, JEANAINE PEARL A. BELTRAN, of legal age, Filipino, married, and a

resident of Teacher’s Village, Barangay Poblacion, Kitaotao, Bukidnon, Philippines, after
having been duly sworn to in accordance with law, hereby depose and say:

1. That I am the same person whose personal circumstances are above-mentioned and
who cause the preparation of this affidavit;

2. That I recently resigned as Municipal Health Officer (MHO)of the Local

Government of Damulog;

3. That I have no pending case whether criminal, civil or administrative in nature,

before any judicial tribunal or administrative agency exercising quasi-judicial
authority in the Philippines;

4. That I am executing this affidavit to inform the proper authorities of whatever legal
purpose this affidavit may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature this February 9,

2021, at Don Carlos, Bukidnon, Philippines.

JEANAINE PEARL A. BELTRAN

Affiant
Valid ID No. Driver’s License No. K03-19-004672

SUBSCRIBED AND SWORN to before me this February 9, 2021, at Don Carlos,

Bukidnon, Philippines, the affiant exhibited to me her competent evidence of identity
indicated below her name and signature.

Doc No. _______;

Page No. ______;
Book No. ______;
Series of 2021.