REPUBLIC OF THE PHILIPPINES )

City of Cagayan de Oro ) S.S.

AFFIDAVIT

I, TEODORO B. OGUIS, of legal age, Filipino citizen, married, with residence at Zone
2, Tubajon, Laguindingan, Misamis Oriental and after having been duly sworn to in accordance
with law, hereby depose and state:

1. That I was the ABC President/ Ex-Officio Sangguniang Bayan Member of the
Municipality of Laguindingan, Misamis Oriental from 2018-2023;

2. That I have applied for Terminal Leave/Resignation effective

_______________________;
3. That by reason of such application, I am relieving the Local Government Unit (LGU)
of Laguindingan, Misamis Oriental from any liabilities for my remaining financial
obligations, if any;
4. That I hereby further voluntarily manifest that I am authorizing the LGU Laguindingan
to deduct any financial accountabilities from salary, receivables or monetary benefits
that I may be entitled to from the said LGU;
5. That I have executed this affidavit to attest to the truth of the foregoing statements and
for the proper guidance and information of the LGU Laguindingan and for other legal
purpose this affidavit may have its worth.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____________ at

Cagayan de Oro City.

TEODORO B. OGUIS
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this ______________ at Cagayan de

Oro City, who is known by me to be the same person who executed this document and further
exhibited to me his _______________________________ as competent proof of identity.

Doc. No. ________;

Page No. ________;
Book No. ________;
Series of 2024.