Republic of the Philippines )

Province of Negros Oriental ) S.S.

Dumaguete City )

A F F I D A V I T

I, EVELYN A. BANDOQUILLO, married, of legal age, Filipino Citizen,

with residence and postal address at Barangay Poblacion, Mabinay, Negros
Oriental, Philippines, after being duly sworn to in accordance with law,
hereby depose and state:
1. That I am previously employed in the Department of Education (DepEd) as
SPED Teacher I, assigned at Mabinay Central/SPED with SSC, Mabinay,
Negros Oriental;
2. That on 30 December 2022, I retired from the service after serving for
twenty-nine (29) years with the Department of Education;
3. That I have no knowledge of any pending administrative charges and/or
case filed against me in the Department of Agriculture or any other
agency, instrumentalities of the government;
4. That I also have no knowledge of any pending criminal charges and/or
case filed against me in any court, whether in the SC, CA, and RTC or any
other tribunal or agency of the government;
5. That I am executing this Affidavit in compliance with Republic Act 3019,
attesting to the truth and veracity of the foregoing declarations and to
support my application for retirement, for terminal benefit claims and for
any purpose this may lawfully serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 2 May 2023
at Dumaguete City, Negros Oriental, Philippines.

EVELYN A. BANDOQUILLO
Affiant
ID No.: 2091-0754-1729-3046
Expiry:
Issued by: Rep. of the Phils.
SUBSCRIBED AND SWORN to before me in Dumaguete City, Negros
Oriental, Philippines, this 2 May 2023, affiant exhibiting to me her proof of
identification written below her name, with the corresponding number, date
and place of issuance.

ATTY. ANTHLYN EVE I. PELESMINO

NOTARY PUBLIC
Not. Comm. No. 2022-027
For Dumaguete City and Mun. of Sibulan, Valencia,
Bacong, Dauin, Zamboanguita and Siaton, Neg. Or.
Doc. No.: ; R o l l N o . : 7 6 5 9 8
PTR No.: 11734, 12/29/2022, Dumaguete City
Page No.: ;
IBP No.: 255429, 12/29/2022, Pasig City
Book No.: I ;
Series of 2023 .