REPUBLIC OF THE PHILIPPINES )

SURIGAO CITY ) S.S.

AFFIDAVIT
(Being Single)

I, JENEREX LOGREPAS MOZAR, 23 years old, single, Filipino, and resident of

Brgy. Urbiztondo, Claver, Surigao del Norte, Philippines, after having been duly sworn
to in accordance with law, hereby DEPOSE and SAY, that:

1. I was born on December 13, 1999, at Brgy. San Francisco, Mainit, Surigao del
Norte from spouses BARTOLOME S. MOZAR (deceased), and TERESITA M.
LOGREPAS;

2. I am an applicant for an entry position at the Armed Forces of the Philippines

(AFP), Philippine Army (PA);

3. As of this date and the execution of this legal instrument, I am not yet married, or
that my civil status, pursuant to Philippine laws, is “SINGLE”;

4. I hold myself criminally and administratively liable for perjury and dishonesty
should any statement made herein be found to be false and contrary to law;

5. I am executing this Affidavit to attest to the truth and veracity of the foregoing
statements in connection with my application to the Philippine Army, and for any
legal intents/ purposes.

IN WITNESS WHEREOF, I/ We have hereunto affixed my signature this 22nd day of

March 2023, at Surigao City, Surigao del Norte, Philippines.

JENEREX LOGREPAS MOZAR

Affiant

Philhealth ID: 18-025317503-4

SUBSCRIBED AND SWORN to before me this 22nd day of March 2023, at

Surigao City, Surigao del Norte, Philippines, the affiant exhibiting to me his/her
(Government) issued I.D..

ATTY. GERAMER V. DURATO

Public Attorney I
(Pursuant to R.A. 9406)