TEMPLATE: AFFIDAVIT OF NO RELATIONSHIP

REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF TACLOBAN ) S.S.

AFFIDAVIT OF NO RELATION

I, __________________________, of legal age, _________, ___________, and residing at

___________ CITY, after having been duly sworn in accordance with law, do hereby depose and state
that:

1. I am applying for a space rental at Daniel Z. Romualdez Airport for Advertising purposes.

2. That I have no relatives within the fourth degree either of consanguinity or affinity who is an
incumbent employee in the subject branch:

3. That should the Civil Aviation Authority of the Philippines (CAAP) ascertain that I have
relatives employed, the Civil Aviation Authority of the Philippines reserves the right to
cancel the processing of my application.

4. That I understand that should I be approved of my application, any misrepresentation on that

matter is ground for an administrative case and termination.

5. That this affidavit is executed to attest to the veracity of the foregoing statements.

IN THE WITNESS WHEREOF, I have hereunto set my hand this _________ day __________ at
TACLOBAN CITY, Philippines.

______________________________________
Bidder’s Representative/ Authorized Signatory

SUBSCRIBED AND SWORN to before me this ____ day of _________ at _________,

Philippines. Affiant/s is/are personally known to me and was/were identified by me through
competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-8-
13-SC). Affiant/s exhibited to me his/her Passport, with his/her photograph and signature
appearing thereon, with no.____ and his/her Community Tax Certificate No.___ issued on _____
at TACLOBAN CITY, LEYTE.

Witness my hand and seal this _____ day of ___________.

NAME OF NOTARY PUBLIC

Serial no. of Commission____________