Republic of the Philippines )

Kawit, Cavite )

AFFIDAVIT OF NON-FILING OF INCOME TAX RETURN

(ITR)

WE, NORMELITA Y. BATOY and FREDDIE L. BATOY both of legal age,

Filipinos, and resident of Blk 3 Phase 1, Bagong Silang, Brgy. Queensrow East,
Bacoor City, Cavite after being duly sworn according to law, depose and state
that:

1. We are the biological parents of VINCE GRAY YLANAN BATOY;

2. Our aforesaid son will undergo kidney transplant;

3. We are applying for medical assistance and one of the requirements for
such application is the presentation of Income Tax Return (ITR) of his
parents, which we have none, hence, this affidavit;

4. We are not gainfully employed in any private/public entity, thus, We are

not filing any Income Tax Return with the Bureau of Internal Revenue;

5. We are exempted in doing so;

6. We are executing this affidavit to attest to the truth of all the foregoing
and to satisfy the requirements of any person or office in support of our
son’s application and for other legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 27 th day of

January 2022 in Kawit, Cavite.

NORMELITA Y. BATOY FREDDIE L. BATOY

Affiant Affiant

SUBSCRIBED AND SWORN to before me this 27th day of January 2022 in

Kawit, Cavite, affiant exhibiting to me her TIN 489-100-959-000 and UMID ID
with No. CRN-0033-2959712-3.

Doc. No. 255

Page No. 52
Book No. VI
Series of 2022