REPUBLIC OF THE PHILIPPINES)

PROVINCE OF BOHOL )
MUNICIPALITY OF INABANGA ) S.S.
x------------------------------------------------x

AFFIDAVIT OF NO RELATIVE

I, ____________________, of legal age, Filipino, married, and a

resident of, Cogon, Inabanga, Bohol, after having been duly sworn to in
accordance with law, depose and state THAT:

1. I am the affiant named above;

2. I was a Barangay Kagawad in the Barangay of Cogon, Municipality of

Inabanga, Province of Bohol from 2013 - 2018.

3. During my term of office none of the other elective official is my

relative within 4th civil degree by consanguinity or affinity;

4. That I am executing this affidavit to attest to the foregoing facts, to

comply with the requirements for the Application for Grant of Eligibility
Pursuant to R.A 7160 and for any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

__________________ in Inabanga, Bohol, Philippines.

________________
Affiant

SUBSCRIBED AND SWORN TO before me this ________________ in

Inabanga, Bohol, Philippines by the Affiant who personally appeared before
me and known to me and to me known to be the same person who executed
the foregoing Affidavit. I hereby certify that I have personally examined the
Affiant who affirmed to me that she executed the foregoing Affidavit freely
and voluntarily.