Social Security System

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REPUBLIC OF THE PHILIPPINES )

CITY OF CABANATUAN ) S.S.

AFFIDAVIT

I, AMIE D.S. DELA CRUZ of legal age, Filipino, single and a resident of, #25 Purok
2, Brgy. Mabuhay, Talavera, Nueva Ecija, after having been sworn to in accordance with
law, hereby depose and state the following:

1. That I have two dissimilar signature strokes appeared in the Scholarship


Training Voucher and Daily Attendance Sheet (attached as Annex “A” & Annex
“B” respectively) and Assessment Attendance Sheet (Attached as Annex “C”) of
AIDA ROQUE ACADEMY OF HAIR AND BEAUTY INC.;

2. That AMIE D.S. DELA CRUZ with the following signature stroke as appearing in
the Scholarship Training Voucher and Daily Attendance Sheet to wit: supply

________________ _________________ _________________

and AMIE D.S. DELA CRUZ with the following signature stroke as appearing in
the Assessment Attendance Sheet to wit:

________________ _________________ _________________

Is one and the same person.

3. That I am executing this Affidavit to attest to the truthfulness of this fact and for
whatever legal purposes it may serve.

IN WITNESS WHEREOF, WE have hereunto affixed our signature this ____ day of
_____________________________ at Cabanatuan City. Fill out

AMIE D.S. DELA CRUZ


Affiant
ID No.______________

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.


REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT

WE, SPS. BENITO A. DELA CRUZ and CRESENCIA H. DELA CRUZ of legal
ages, Filipinos, and residents of #202 Brgy. Lourdes, Sta. Rosa, Nueva Ecija, after having
been sworn to in accordance with law, hereby depose and state the following:

4. That we are willing to buy in cash amounting to NINE MILLION (Php


9,000,000.00) Philippine Currency the residential lot of DAN REY BRIONES
located at Brgy. Quezon Dist., Cabanatuan City, Nueva Ecija, Philippines with
an area of THREE HUNDRED SEVENTY FOUR (374) square meters more or
less under Transfer Certificate of Title No. T-90187 with all improvements
thereon in which the 5% negotiator’s/agent’s commission to AHSER D.
EDUARDO of Blk. 7 Lot 23 & 24 Sta. Rosa Homes, Lourdes, Sta. Rosa, Nueva
Ecija will be in the accountability of the Seller.

5. That we are executing this Affidavit to attest to the truthfulness of this fact and
to support our proposal to buy with DAN REY BRIONES and for any legal
purposes it may serve.

IN WITNESS WHEREOF, WE have hereunto affixed our signature this ____ day of
_____________________________ at Cabanatuan City.

SPS. BENITO A. DELA CRUZ CRESENCIA H. DELA CRUZ


Affiant Affiant
ID No.: ___________________ ID No.: ___________________
Issued by:_________________ Issued by:_________________

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiants and am convinced that they
voluntarily executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.


REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF EXPLANATION

I, GLORIA B. GUINTO, of legal age, Filipino, and a resident of Sto. Cristo Sur,
Gapan, Nueva Ecija, after having been sworn to in accordance with law, hereby depose
and state the following:

6. That I am the authorized representative/Chief Finance Officer/Treasurer of


GLORIOUS HOPE ACADEMY OF GAPAN CITY INC. located at 357
Maharlika Highway, Sto. Cristo, Gapan City, Nueva Ecija to pay and transact
with the Social Security System (SSS);

7. That GLORIOUS HOPE ACADEMY OF GAPAN CITY INC. has an employer


ID No. 02-0962620-1 with the Social Security System (SSS) and paying its
Contribution regularly to the SSS Cabanatuan City;

8. That during the months of April and May 2016 and 2017, our employees have
no earnings because of the students’ vacation (as per their contract of
employment from June to March), thus, the school does not pay its monthly
premiums during the said period;

9. That I admit it is my fault and negligence I did not report with the SSS that our
employees have no earnings during the said periods and I would like to
apologize for my mistake to the SSS;

10. That this Affidavit is to attest to the truthfulness of this fact and to support my
request with the Social Security System to accept my apology and for any legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


_____________________________ at Cabanatuan City.

GLORIA B. GUINTO
Affiant
TIN: 219-846-456

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.


REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF EXPLANATION

I, REV. BRYAN M. ESMERIA, of legal age, Filipino, and a resident of Talabutab


Norte, Gen. Natividad, Nueva Ecija, after having been sworn to in accordance with law,
hereby depose and state the following:

11. That I am the authorized representative of TALABUTAB NORTE METHODIST


LEARNING CENTER INC. located at Corner Sanciangco and Del Pilar Sts.,
Cabanatuan City, Nueva Ecija to pay and transact with the Social Security
System (SSS);

12. That THE BETHANY CHRISTIAN ACADEMY in Cabanatuan City has an


employer ID No. 02-0942783-1 with the Social Security System (SSS) and
paying its Contribution regularly to the SSS Cabanatuan ;

13. That during the months of March, April and May 2011, our employees has no
earnings because of the student’s vacation, thus, the school does not pay its
monthly premiums during the said period;

14. That also in November, 2011 to May, 2012, the school cannot pay its monthly
contribution with the SSS because the school suffered financial losses during
that time and our employees was not able to pay their salaries;

15. That starting on January, 2013 the school continue to suffered financial losses
that results us to close our school until the present time, hence we have no
more employees/teacher and we also did not pay the monthly contributions
with the SSS;

16. That I admit it is my fault and negligence I did not report with the SSS that our
employees has no earnings during the said periods and I would like to
apologize for my mistake to the SSS;

17. That this Affidavit is to attest to the truthfulness of this fact and to support our
request with the Social Security System to accept my apology and for any legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


_____________________________ at Cabanatuan City.

GLENDA O. PASCUAL
Affiant
SSS No. 02-21303997

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF EXPLANATION

I, GLENDA O. PASCUAL, of legal age, Filipino, and a resident of Talabutab Norte,


Gen. Natividad, Nueva Ecija, after having been sworn to in accordance with law, hereby
depose and state the following:

18. That I am the authorized representative of THE BETHANY CHRISTIAN


ACADEMY located at Corner Sanciangco and Del Pilar Sts., Cabanatuan City,
Nueva Ecija to pay and transact with the Social Security System (SSS);

19. That THE BETHANY CHRISTIAN ACADEMY in Cabanatuan City has an


employer ID No. 02-0942783-1 with the Social Security System (SSS) and
paying its Contribution regularly to the SSS Cabanatuan ;

20. That during the months of March, April and May 2011, our employees has no
earnings because of the student’s vacation, thus, the school does not pay its
monthly premiums during the said period;

21. That also in November, 2011 to May, 2012, the school cannot pay its monthly
contribution with the SSS because the school suffered financial losses during
that time and our employees was not able to pay their salaries;

22. That starting on January, 2013 the school continue to suffered financial losses
that results us to close our school until the present time, hence we have no
more employees/teacher and we also did not pay the monthly contributions
with the SSS;

23. That I admit it is my fault and negligence I did not report with the SSS that our
employees has no earnings during the said periods and I would like to
apologize for my mistake to the SSS;

24. That this Affidavit is to attest to the truthfulness of this fact and to support our
request with the Social Security System to accept my apology and for any legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


_____________________________ at Cabanatuan City.
GLENDA O. PASCUAL
Affiant
SSS No. 02-21303997

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, GERARDO M. REYES, of legal age, Filipino, and a resident of Kapt. Pepe Subd.
Cabanatuan City, Nueva Ecija, after having been sworn to in accordance with law, hereby
depose and state the following:

25. That I am a member/contributor of Social Security Syatem with SSS No. 02-
1189631-7;

26. That I applied for change of employment from “EMPLOYED” to “SELF-EMPLOYED”


sometimes in 2001;

27. That since I changed to SELF-EMPLOYED, I also continue my regular


payment/contribution to SSS starting MARCH 2001 as per my self-employed
actual premium payments paid on March 15, 2001 and receipt no. 089494 the
amount of P 84.00 (Annex “A”);

28. That due to unavoidable circumstances, my said Application for change of


employment together with my payment receipts were lost and despite diligent
effort, I could no longer locate the same;

29. That this Affidavit is to attest to the truthfulness of this fact and to support my
request with the Social Security System to update my contribution and for any
legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 24 th day of


November, 2014 at Cabanatuan City.

GERARDO M. REYES
Affiant
SSS No. 02-1189631-7

SUBSCRIBED AND SWORN to before me at the place and date above stated. I hereby
certify that I personally examined the affiant and am convinced that he voluntarily executed
the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

ATTY. JEREMIAS C. GARCIA


Doc. No. 141 Notary Public
Page No. 33 Until December 31, 2014
Book No. 44 PTR.No. CBN-0437731, Cab, City-12-27-
2013
Series of 2014 IBP No 880711,12-27-13, N.E.
Chapter
Roll No. 45770, MCLE IV-
0002636

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF EXPLANATION

I, GLENDA O. PASCUAL, of legal age, Filipino, and a resident of Talabutab Norte, Gen.
Natividad, Nueva Ecija, after having been sworn to in accordance with law, hereby depose and
state the following:

30. That I am the Bookkeeper and authorized representative of UNITED METHODIST


CHURCH CITY TEMPLE (UMCT) located at Corner Santiago and Del Pilar Street
Cabanatuan City;

31. That UNITED METHODIST CHURCH CITY TEMPLE in Cabanatuan City has an
employer ID No. 02-0498600-1 with the Social Security System (SSS) and paying
its Contribution regularly to the SSS Cabanatuan ;

32. That JULIET TEJADA PASCUA with SSS No. 08-0909820-0 is an employee of
UNITED METHODIST CHURCH CITY TEMPLE since June 2013 up to present and
her monthly contribution to SSS was regularly remitted to SSS as per SSS
Employer Contributions Payment Return (R-5);
33. That UMCT submits the SSS Contribution Collection List (R3) regularly to SSS,
however, upon application for loan of Ms. Juliet Pascua, we found out that her SSS
No. was inadvertently reported as SSS No. 02-0909820-8 instead of 08-0909820-0
from June 2013 to May 2014;

34. That this Affidavit is to attest to the truthfulness of this fact and to support our
request with the Social Security System to update the contribution of JULIET
TEJADA PASCUA and for any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


_____________________________ at Cabanatuan City.

GLENDA O. PASCUAL
Affiant
SSS No. 02-21303997

SUBSCRIBED AND SWORN to before me at the place and date above stated. I hereby
certify that I personally examined the affiant and am convinced that she voluntarily executed
the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

OUTREACH PHILIPPINES INC.


630 Sampaguita St., Milbuena Subd.,
Magsaysay Sur, Cabanatuan City

August 29, 2014

MS. MARIE ADA ANGELIQUE T. DE SILVA


Officer –in-Charge, SOCIAL SECURITY SYSTEM
12th Flr. SSS Main Building Department East Ave., Diliman
Quezon City

Dear Madam;

Christian greetings!
We would like to inform your end that the our former employee of OUTREACH
PHILIPPINES INC. in Cabanatuan City, HONEY ROCEHL V. SAPITAN with
SSS No. 02-2388077-7, resigned from OUTREACH PHILIPPINES, INC. on
November 30, 2011 and is therefore no longer connected with us.

Hence, we are requesting your end to delete her name, HONEY ROCEHL V.
SAPITAN from the list of employees of OUTREACH PHILIPPINES INC. for SSS
purposes effective on the date of her resignation on November 30, 2011.

Thank you for this and past favors.

Very truly yours,

EMILY E. GARUBO
Administrative Officer, OUTREACH PHILIPPINES INC.
SSS Employer ID No. 02-0917596-9

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF DELETION OF NAMES RESIGNED EMPLOYEES

I, EMILY E. GARUBO, of legal age, Filipino, the Administrative Officer of the OUTREACH
PHILIPPINES INC. with an office address at 630 Sampaguita St., Milbuena Subd. Magsaysay
Sur, Cabanatuan City , after having been sworn to in accordance with law, hereby depose and
state the following:

35. That I am the Administrative officer and authorized representative of OUTREACH


PHILIPPINES INC. in Cabanatuan City;

36. That OUTREACH PHILIPPINES INC. in Cabanatuan City has an employer ID No. 02-
0917596-9 with the Social Security System (SSS);

37. That our former co-employee/worker in OUTREACH PHILIPPINES INC. namely


HONEY ROCEHL V. SAPITAN with SSS No. 02-2388077-7 resigned on November
30, 2011 and is therefore no longer connected with us;
38. That this Affidavit is to attest to the truthfulness of this fact and to support our
request with the Social Security System to delete her name, HONEY ROCEHL V.
SAPITAN from the list of employees of OUTREACH PHILIPPINES INC. in
Cabanatuan City for SSS purposes effective on the date of her resignation and for
any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


_____________________________ at Cabanatuan City.

EMILY E. GARUBO
Affiant
SSS No. 02-0649934-7

SUBSCRIBED AND SWORN to before me at the place and date above stated. I hereby
certify that I personally examined the affiant and am convinced that she voluntarily executed
the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

OUTREACH PHILIPPINES INC.


630 Sampaguita St., Milbuena Subd.,
Magsaysay Sur, Cabanatuan City

August 29, 2014

MS. MARIE ADA ANGELIQUE T. DE SILVA


Officer –in-Charge, SOCIAL SECURITY SYSTEM
12th Flr. SSS Main Building Department East Ave., Diliman
Quezon City

Dear Madam;

Christian greetings!

We would like to inform your end that the our former employee of OUTREACH
PHILIPPINES INC. in Cabanatuan City, HONEY ROCEHL V. SAPITAN with
SSS No. 02-2388077-7, resigned from OUTREACH PHILIPPINES, INC. on
November 30, 2011 and is therefore no longer connected with us.

Hence, we are requesting your end to delete her name, HONEY ROCEHL V.
SAPITAN from the list of employees of OUTREACH PHILIPPINES INC. for SSS
purposes effective on the date of her resignation on November 30, 2011.

Thank you for this and past favors.

Very truly yours,

EMILY E. GARUBO
Administrative Officer, OUTREACH PHILIPPINES INC.
SSS Employer ID No. 02-0917596-9

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF DELETION OF NAMES RESIGNED EMPLOYEES

I, NOEL B. SANTIAGO, of legal age, Filipino, the Administrative Pastor of the UNITED
METHODIST CITY TEMPLE with an office address Corner Santiago and Del Pilar Street,
Cabanatuan City , after having been sworn to in accordance with law, hereby depose and state
the following:

39. That I am the Administrative Pastor and authorized representative of UNITED


METHODIST CHURCH CITY TEMPLE in Cabanatuan City;

40. That UNITED METHODIST CHURCH CITY TEMPLE in Cabanatuan City has an
employer ID No. 02-0498600-1 with the Social Security System (SSS);

41. That our former co-employees/workers in UNITED METHODIST CHURCH CITY


TEMPLE namely AURORA R. PAJARILLAGA and GLORIA C. REYES, resigned on June
1, 2002, and GUILLERMA V. ANGELES, resigned on June 1, 2010 and are no longer
connected with us;
42. That EUFROCINA P. PRONTO did not become our employee/worker and is not
connected with us.

43. That this Affidavit is to attest to the truthfulness of this fact and to support our
request with the Social Security System to delete their names, AURORA R.
PAJARILLAGA, GLORIA C. REYES, GUILLERMA V. ANGELES, and EUFROCINA P.
PRONTO from the list of employees of UNITED METHODIST CHURCH CITY
TEMPLE in Cabanatuan City for SSS purposes effective on the respective dates of
their resignation and for any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


_____________________________ at Cabanatuan City.

NOEL B. SANTIAGO
Affiant
SSS No. ___________________

SUBSCRIBED AND SWORN to before me at the place and date above stated. I hereby
certify that I personally examined the affiant and am convinced that he voluntarily executed
the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

UNITED METHODIST CHURCH CITY TEMPLE INC.


Corner Santiago and Del Pilar Street, Cabanatuan City

January 30, 2013

MARIE ADA ANGELIQUE T. DE SILVA


Officer –in-Charge, SOCIAL SECURITY SYSTEM
12th Flr. SSS Main Building Department East Ave., Diliman
Quezon City

Dear Madam;

Christian greetings!

We would like to inform your end that the following former employees of UNITED
METHODIST CHURCH CITY TEMPLE in Cabanatuan City, AURORA R. PAJARILLAGA and
GLORIA C. REYES, resigned on June 1, 2002, and GUILLERMA V. ANGELES, resigned on June 1,
2010 and are no longer connected with us and EUFROCINA P. PRONTO did not become our
employee/worker and is also not connected with us.

Hence, we are requesting your end to delete their names, AURORA R. PAJARILLAGA,
GLORIA C. REYES, GUILLERMA V. ANGELES, and EUFROCINA P. PRONTO, from the list of
employees of METHODIST CHURCH CITY TEMPLE for SSS purposes effective on the
respective dates of their resignation.

Thank you for this and past favors.

Very truly yours,

NOEL B. SANTIAGO
Authorized Representative, UNITED METHODIST CHURCH CITY TEMPLE
SSS Employer ID No. 02-0498600-1

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF TWO DISINTERESTED PERSONS

WE, AMELIA SALATAMOS and MARITES RAMOS, both of legal ages,


Filipinos and residents of Paco Roman, Rizal, Nueva Ecija, after having been sworn to in
accordance with law, hereby depose and state the following:

1. That we know MYLENE GRAGASIN GAMBITO because she is our neighbor,


and a family friend;

2. That MYLENE G. GAMBITO is separated de facto from her husband and has
one daughter;
3. That MYLENE G. GAMBITO and her daughter are living with her parents and
are dependent on them on everything including the education of her daughter;

4. That MYLENE G. GAMBITO is a non-employed, do not have any business or


any source of income and livelihood, hence, an indigent;

5. That this Affidavit is to attest to the truthfulness of this fact and for any other
legal intents and purposes this may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signature this _________


day of ________________ at Cabanatuan City.

AMELIA SALATAMOS MARITES RAMOS


Affiant Affiant
_________ID/CTC No. __________ _________ID/CTC No. __________
Issued on ______________ Issued on ______________
at ____________________ at ____________________

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that they voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF NON RECEIPT

I, JERRY M. OBEDOZA, of legal age, and a resident of Talabutab Norte, General


Natividad, Nueva Ecija, after having been sworn to in accordance with law, hereby depose
and state the following:

1. That I am a holder of Philam Plans Inc. Insurance under Plan No. 3270108401;

2. That I have already fully paid my said Insurance Plan No. 3270108401 with
Philam Plans Inc. in November 2007;
3. That I have not received yet my Certificate of Full Payment for my Insurance
Plan No. 3270108401;

4. That this Affidavit is to attest to the truthfulness of this fact and to support my
request with the Philam Plans Inc. to issue my Certificate of Full Payment.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 27th day of


December, 2011 at Cabanatuan City.

JERRY M. OBEDOZA
Affiant

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that he voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF NON RECEIPT OF SSS ID

I, ADAHLIA TAGALAG BASCO, of legal age, married, and a resident of No. 44


Valino St., Aduas Centro, Cabanatuan City, after having been sworn to in accordance with
law, hereby depose and state the following:

5. That I am an employee of Wesleyan University-Philippines;

6. That as an employee, I am a member of Social Security System (SSS) with SSS


No. 0221388255;

7. That I do not have received yet my SSS ID card;

8. That this Affidavit is to attest to the truthfulness of this fact and to support my
request with the Social Security System to issue my SSS ID Card.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 16th day of


August, 2011 at Cabanatuan City.
ADAHLIA TAGALAG BASCO
Affiant

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF NO BUSINESS

I, LORENZO MANAHAN RIVERA, of legal age, Filipino and a resident of


Talabutab Sur, Gen. Natividad, Nueva Ecija, after having been sworn to in accordance with
law, hereby depose and state the following:

1. That I am an employee of GMA Network, Inc. from September 2007 up to


present ;

2. That I do not have any other business except my employment at GMA Network,
Inc., Manila since September 2007 ;

3. That this Affidavit is to attest to the truthfulness of this fact for any legal
purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7 th day of July,


2011 at Cabanatuan City.

LORENZO MANAHAN RIVERA


Affiant
TIN 306-880-533-000

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that he voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF DELETION OF NAMES RESIGNED EMPLOYEES

I, EMILY E. GARUBO, of legal age, Filipino, an employee and authorized


representative of Outreach Philippines Inc. with an office address 630 Milbuena Subd.
Magsaysay Norte, Cabanatuan City , after having been sworn to in accordance with law,
hereby depose and state the following:

1. That I am an employee and authorized representative of OUTREACH


PHILIPPINES INC., located at 630 Milbuena Subd. Magsaysay Norte,
Cabanatuan City;

2. That OUTREACH PHILIPPINES INC. has an employer ID No. 02-0917596-9


with the Social Security System (SSS);

3. That our former co-employees/workers in OUTREACH PHILIPPINES INC.


namely MARIO S. PADILLA, HERMOGENES LISONDRA JR., and EMALIN
C. LANGRES resigned respectively on April 30, 2007, May 31, 2007 and May
31,2007, and are no longer connected with us ;

4. That this Affidavit is to attest to the truthfulness of this fact and to support our
request with the Social Security System to delete their names, MARIO S.
PADILLA, HERMOGENES LISONDRA JR., and EMALIN C. LANGRES,
from the list of employees of OUTREACH PHILIPPINES INC. in connection
with SSS purposes effective on the respective dates of their resignation and for
any legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this 5th day of
May, 2011 at Cabanatuan City.

EMILY E. GARUBO
Affiant
SSS No. 02-0649934-7

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

May 5, 2011

MARIE ADA ANGELIQUE T. DE SILVA


Officer –in-Charge, SOCIAL SECURITY SYSTEM
12th Flr. SSS Main Building Department East Ave., Diliman
Quezon City

Dear Madam;

Christian greetings!

We would like to inform your end that the following former employees of OUTREACH
PHILIPPINES INC., MARIO S. PADILLA, HERMOGENES LISONDRA JR., and
EMALIN C. LANGRES resigned respectively on April 30, 2007, May 31, 2007 and May
31, 2009, and are no longer connected with us.

Hence, we are requesting your end to delete their names, MARIO S. PADILLA,
HERMOGENES LISONDRA JR., and EMALIN C. LANGRES, from the list of employees
of OUTREACH PHILIPPINES INC. in connection with SSS purposes effective on the
respective dates of their resignation.

Thank you for this and past favors.

Very truly yours,

EMILY E. GARUBO
Authorized Representative, Outreach Philippines Inc.
SSS Employer ID No. 02-0917596-9
REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF NON-EMPLOYED

I, MA. CRISTINA C. BAO, of legal age, Filipino and a resident of Quezon St., Pob.
Sur, Rizal, Nueva Ecija, after having been sworn to in accordance with law, hereby depose
and state the following:

5. That I was born in Cabanatuan City to the Spouses Rolando D. Bao, Sr. and
Virginia G. Cadapan on December 8, 1981;

6. That as per my Birth Certificate, my registered name is MARIA LUISA


CABAYAN BAO but I am presently using MA. CRISTINA CADAPAN BAO;

7. That I need to rectify my registered first name to MA. CRISTINA CADAPAN


BAO;

8. That I finished the degree Bachelor of Science in Commerce at Wesleyan


University-Philippines, Cabanatuan City last April 2003;

9. That from November 2003 to June 2005, I was employed as a contractual


employee in different companies;

10. That from June 2005 up to present, I am not employed;

11. That this Affidavit is to attest to the truthfulness of this fact and to support for
my petition for change of first name as a non-employed individual.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7th day of


November, 2005 at Cabanatuan City.

MA. CRISTINA C. BAO


Affiant
CTC No. 09982803
Issued on November 7, 2005
at Cabanatuan City
SUBSCRIBED AND SWORN to before me at the place and date above stated with
affiant exhibiting to me her Community Tax Certificate indicated below her name. I hereby
certify that I personally examined the affiant and am convinced that she voluntarily
executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF NON-EMPLOYMENT

I, FELIPE G. DAYAO, of legal age, Filipino and a resident of Sta. Barbarra, San
Antonio, Nueva Ecija, after having been sworn to in accordance with law, hereby depose
and state the following:

6. That I am the legal husband of late Aida R. Dayao as per attached Certificate of
Marriage from the National Statistic Office (NSO);

7. That Aida R. Dayao my wife died last December 03, 2009 as per attached
Death Certificate from the National Statistic Office (NSO);

8. That I am unemployed and does not receive or earn a regular income and is not
a member of Social Security System (SSS);

9. That this Affidavit is to attest to the truthfulness of this fact and to support my
benefits claim from Government Service Insurance System (GSIS) as a legal
beneficiary.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 21 st day of


March, 2011 at Cabanatuan City.

FELIPE G. DAYAO
Affiant
ID/CTC No. ____________
Issued on ______________
at ____________________
SUBSCRIBED AND SWORN to before me at the place and date above stated with
affiant exhibiting to me his Community Tax Certificate indicated below his name. I hereby
certify that I personally examined the affiant and am convinced that he voluntarily executed
the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

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