REPUBLIC OF THE 

PHILIPPINES)
CITY OF DUMAGUETE) S.S.

  

SWORN STATEMENT

I, MELCER S. SABLA-ON, of legal age, married, Filipino, and a resident of Purok 1,

Poblacion Mabinay, Negros Oriental, after having been sworn to in accordance with law
hereby depose and say:

1. That I just had engage in the farming of sugar cane on a parcel of land situated in
Barangay Inapoy, Mabinay Negros Oriental with an area of 1.5 hectares;

2. That I hereby declare under pain of perjury that my gross income does not
exceed Php300,000;

3. That I likewise declare that I have no other source of income to augment my

income from sugar cane farming, it being my only means of livelihood;

4. That I am executing this Affidavit to attest the truthfulness of the foregoing

statements and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, I hereby affixed my signature/s this day of

___________________ in Dumaguete City, Philippines.

MELCER S. SABLA-ON
Affiant
National ID No. 7326-7052-8406-4315

SUBCRIBED AND SWORN TO before me this ___________________ in

_________________, Philippines, affiant/s exhibiting to me his competent proof of
identity.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2022.