REPUBLIC OF THE PHILIPPINES))S.S.

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AFFIDAVIT

I, __________________________, of legal age, Filipino, and a resident of ____________________________________, Philippines after first being sworn to in accordance with law hereby depose and state:

1. From 1989 to _____________________, I was working in the Embassy of the Philippines in Tehran, Iran;

2. Being an OFW, I did not file my Income Tax Returns (“ITR”) during the above-mentioned period;

3. From years 2013 to 2014, I did not work for any company nor was I engaged in any business.

4. I am executing this affidavit in lieu of the requirement of the Philippine Overseas Employment Administration to submit my ITR for the year 2013 and 2014 for our company, ALPHASONIC INTERNATIONAL MANPOWER AGENCY, INC.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________________ at ____________________, Philippines.

______________________________ Affiant

SUBSCRIBED AND SWORN to before me this _____________________, in the _____________, Philippines.

NOTARY PUBLIC

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