Republic of the Philippines )

City of Mandaue ) S.S.

AFFIDAVIT OF DENIAL

I, RRR, of legal age, Filipino and a resident of Brgy. Bakilid, Mandaue City,
Cebu, having been duly sworn in accordance with law, do hereby depose and state:

1. That I applied for National Bureau of Investigation (NBI) Clearance; however, I

was informed by the office that there is a RRR in their records having pending
criminal cases.

2. The Philippine Immigration requested me to affirm or deny my alleged

involvement;

3. That I am not the same person referred to in the cases found by the said office in
their records as I have never been involved in nor charged of any crime;

4. That I execute this affidavit to deny any involvement in any crime and to clear
my name of whatever adverse records on file with the National Bureau of
Investigation.

IN WITNESS WHEREOF, I have hereunto set my hand this 18 th day of January

2023 in the City of Mandaue.

RRR
Driver’s License No. XXX

SUBSCRIBED AND SWORN to before me this 18 th day of January 2023 in the

City of Mandaue affiant exhibited to me his competent proof of identity stated-above.