Republic of the Philippines )

City of Laoag ) S. S.

AFFIDAVIT

_________________________, through its authorized representative, with

business address at Brgy. ________________________________, under oath, do
hereby depose and state:

1. That our business has engaged RCB DISTRIBUTIONS CORP. as our regular
supplier of ___________________________;

2. That we have made a purchase of Golden Coolers and Young’s Town

worth P120,966.80 from RCB on September 7, 2021, September 21,
2021 and October 16, 2021, respectively, as evidenced by hereto
attached receipts;

3. That we purchased them on credit and have already made several

installment payments in the amount of P79,366.80 which was personally
delivered to and received by Raymond V. Topino;

4. That the remaining balance of 41,600 has already been paid and
received by the new agent/employee of RCB;

5. That RCB is demanding us to pay the amount of P79,366.80, however,

we are insisting that said amount has already been paid to Raymond V.
Topino;

6. That we are executing this affidavit to attest to the truthfulness of the

foregoing facts for all legal intents and purposes it may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this

_________________ at Laoag City, Philippines.
 _________________________

Affiant

Owner/Authorized Representative

Of __________________________

SUBSCIBED AND SWORN to before me this ________________________ at

Laoag City, Philippines, affiant exhibited to me her __________________ bearing
number indicated below her name and signature.