REPUBLIC OF THE PHILIPPINES)

_____________________________) S.S

SWORN AFFIDAVIT

I, _____________________, _______________________ with Passport No. ___________,

of legal age and capacity, after having duly sworn in accordance with law, hereby depose and
state, to wit:

1. That I am executing this affidavit to attest that my previous employer,

_____________________________ with company address at
__________________________________ Philippines is already closed and has stop
operating last ______________________.

2. That I hereby confirm that due to the company closure, I can no longer provide the
certificate of employment and corporate signatory ID.

3. That I am executing this Sworn Affidavit in compliance with the requirements for the
_____________________________________________________________________
______________.

4. That affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand this ________________________ at

________________________.

__________________________
Affiant

SUBCRIBED AND SWORN TO before me this ________________________ in

________________________ affiant exhibiting to me his/her competent evidence of identity
by way of _________________________________________________________ issued at
________________________ on ________________________.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023.