Republic of the Philippines)

City of Cebu) S.S.

AFFIDAVIT

I, Allan Baterzal, a resident of 2/F No. 21 Hillside, Talamban, Cebu City, after having been duly sworn to
in accordance with law hereby depose and state that:

1. I am an employee of Jehan Shipping Corporation, serving as a Second Engineer of its vessel M/V
Jehan 3;
2. I was hired by Jehan Shipping Corporation on September 17, 2015;
3. On the date of my hiring, I was informed by their Human Resource Officer Rose Ann Sereno to
submit my SSS, Philhealth and Pag-Ibig numbers to enable to company to post the premium
contributions to the respective agencies, or to submit the requirements for my enrollment to
SSS, Philhealth, and Pag-Ibig;
4. When I did not give it to her, she explained to me that she cannot enroll as she has no
supporting documents and without the SSS, Philhealth, and Pag-Ibig numbers, she cannot post
the contributions to SSS, Philhealth and Pag-Ibig since these agencies will not accept the
company’s payment;
5. Up to today, despite repeated follow-ups, I still have not submit the documentary requirements
for enrollment and/or for posting of my contributions;
6. I am fully aware that it is because of my willful neglect that the company has not been able
remit its contributions to SSS, Philhealth and Pag-Ibig and consequently I was not also deducted
with the employee’s share;
7. Because of these, I am hereby (1) waiving my right, including the right of my sposes, children,
relatives and others to the entitlement of any and all benefits provided under SSS, Philhealth,
and Pag-Ibig laws (2) waiving my right to contest and question the company’s non remittance of
my contributions (3) agree that my monthly contributions and my entitlement to benefits
thereto shall only begin when I have submitted my SSS, Philhealth, and Pag-Ibig numbers;
8. I also agree to hold Jehan Shipping Corporation free and harmless from any liability that may
arise from my willful neglect to submit the requirements to enable my enrollment at SSS,
Philhealth and Pag-Ibig;
9. I also agree that should Jehan Shipping Corporation be made to pay the required contributions
in arrears, Jehan Shipping Corporation shall only pay the unpaid employer’s share, and I shall
shoulder the interest that the government agencies imposed on the employer’s share,
employee’s share and the interest on the employee’s share through a one-time salary
deduction, or should it be insufficient, to pay Jehan Shipping Corporation within five (5) days
from notice;
10. I am executing this affidavit to attest to the truth of the foregoing statements and for whatever
legal purpose this may serve.
 Allan B. Baterzal

Affiant

Subscribed and sworn to before me this ___ day of June 2015, affiant personally appeared and exhibited
to me his Competent Evidence of Identity: ` , issued on
, and expiring on .

Doc No.

Page No.

Book No.

Series of 2016.