AFFIDAVIT

I, ___________________, of legal age, Filipino, married and with residence

and postal address at ____________________________, after being duly sworn to in
accordance with law, depose and state:

1. That all documents I have submitted hereto to support the updating of my

contractor’s information with Department of Public Works and Highways (DPWH)
are genuine and authentic.

2. That I hold myself liable for perjury, falsehood, misrepresentation or any act of
dishonesty for any fraudulent, false, and tampered documents that I have
submitted.

3. That I herby authorize Department of Public Works and Highways (DPWH) to

investigate and verify the documents herein submitted.

In witness thereof, I have hereunto affixed my signature this _______ day of

_____________, 202_ at _________________________, Philippines.

______________________

AFFIANT

REPUBLIC OF THE PHILIPPINES )

CITY OF )

SUBSCRIBED AND SWORN to before me in the _______________________ this

____ day of ______________, _______ by _______________________, who has
satisfactorily proven to me his/her identity through
his/her______________________________, valid until ________________, that
he/she is the same person who is personally signed before me the foregoing Affidavit
that he/she executed the same.
NOTARY
PUBLIC
Doc. No. ____________;
Page No. ____________;
Book No. ____________;
Series of ____________.