REPUBLIC OF THE PHILIPPINES )
CITY OF                             ) S.S.
PROVINCE OF ________________________)
                       AFFIDAVIT OF NO PENDING CASE
      I, DIOSDADO S. AGUSTIN, of legal age, Filipino, married, and a resident of Purok 1,
Barangay Anunas, Angeles City, after having been sworn to in accordance with law, hereby
depose and state:
       1. That I have never been involved in any unlawful activities nor have been charged
          administratively;
       2. That I have never been found guilty/convicted of any administrative offense
          and/or crime;
       3. That there is no pending criminal investigation or prosecution against me;
       4. That I am executing this affidavit in order to attest to the truth of the foregoing
          facts and for whatever legal purpose it may serve.
       AFFIANT SAYETH NONE.
        IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of
_____________________ in _____________________.
                                                           DIOSDADO S. AGUSTIN
                                                                      (Affiant)
                                                           Senior Citizen’s ID No. CH-1395
                                                           Issued by: Office of the Senior
                                                           Citizens Affairs, Angeles City
                                                           Issued on: August 15, 2012
        SUBSCRIBED AND SWORN TO before me this _____day of ___________________, 2019 in
__________________, _______________, Philippines, affiant exhibiting to me ____competent proof of
identity as found below his/her name.
Doc. No. __________;
Page No. __________;
Book No. __________;
Series of 2019.