REPUBLIC OF THE PHILIPPINES) S.

AFFIDAVIT OF NON-SUBMISSION OF DOCUMENT (BIR 2316)

I, __Joshua Villanueva Cortez_, of legal age Filipino and a resident of Rome Street Block 22 Lot
42 Metro Clark Homes Mawaque Mabalacat Pampanga having been duly sworn to in accordance with
law hereby state that:

1. I was hired by DCX Philippines Inc. as _Home Based Promotional Customer Service
Representative.

2. As part of the pre-onboarding requirements as a new employee, I have been requested by

DCX Philippines Inc. to submit my 2022 BIR 2316 form from my previous employer in order consolidate
my income for the year 2022.

3. However, I failed to submit the said form because it hasn’t been released yet by my
previous employer.

4. In lieu of the BIR Form 2316, I am executing this affidavit to waive my right for the accuracy of
the computation of my earnings for the said year. I am holding myself responsible for whatever
deficiency withholding taxes that may due.

IN WITNESS WHEREOF, I have hereunto signed my name this in _____________

______________________.

Affiant

Joshua Villanueva Cortez ID/CTC No.

Valid Until
Philippines

SUBSCRIBED AND SWORN TO before me this at Philippines.

Doc No. __________

Page No. __________

Book No. __________

Series of 2022