REPUBLIC OF THE PHILIPPINES)CITY OF COTABATO ) S.S.

AFFIDAVIT OF NON CHILD SUPPORT
I, ____________, of legal age, married, Filipino citizen and residing
at __________, after having been duly sworn to according to law, hereby depose andstate:1. That I am the
legitimate spouse of _______________ who is also of legalage, and with postal address of ______________. He is active
member of thePhilippine Army with a rank of __________ and he is currently assigned at _______________;2. That me
and my husband have been married on ________________ byand before Rev/Pastor __________________ of the Parish
of Our Lady ofSorrows, ___________ City, copy of the Marriage Certificate is being attachedhereto.3. That out of said
marriage one legitimate child was born, namely, ____________________, six years old and is currently a Grade
1 pupil at (school) ______________;4. That on or about ______________, without justifiable reason, abandonedthe
conjugal home, leaving me and our child, and since then, he has failed andrefused, and still fails and refuse to provide for the
support and maintenance of meand my minor child.5. That I just recently got employed with a minimum monthly income
of __________, while my husband is a government employee (uniform service),earning an average monthly
income of _______________, more or less;6. That considering the present cost of living, me and my child need amonthly
allowance of, at least P5,000-P10,000.00 for our maintenance andsupport.7. That me and my child is currently living with my
old parents, from whomwe depend for support and maintenance. However, the support we receive fromour parents is not
enough considering that they are old and have their ownmaintenance for their health as well, wherein
my father’s source of income is
onlyhis current monthly pension amounting to P,5000.00 (sample), while my motherhas no source of income and is also
dependent to my father.8. That our parents are forced to support us out of pity and compassion;

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9. That most of the times I am forced to beg for money and other necessitiesfrom my younger brother just to
keep my child alive.10. That I am executing this affidavit in order to attest to the truth of theforegoing circumstances and also for
this to serve as my written demand to myhusband for the support and maintenance of me and my child.IN WITNESS
WHEREOF, I have hereunto set my hand this ____ day ofJuly 2018, at the City of
Cotabato. ____________________ AffiantSUBSCRIBED AND SWORN to before me, this _____________,
by ______________ who exhibited to me (his/her) government-issued identificationcard with ID No.
_________ issued on _______________at ______________,Philippines.NOTARY
PUBLICDoc. No. ______Page No. ______Book No. ______Series No. ______