Republic of the Philippines

City of Manila

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AFFIDAVIT
I, JUAN DELA CRUZ, of legal age, Filipino, and a resident of No.
1234, Pedro Gil Street, Malate, Manila, after having been sworn to in
accordance with law, hereby depose and state the following:
1.

I am applying for the position of ATTORNEY VI in Philippine

Overseas Employment Administration;

2.

That I have no relatives within the third degree either of

consanguinity or affinity who is an incumbent employee in the
subject branch;

3.

That should the Department of Labor and Employment ascertain

that I have relatives in Philippine Overseas Employment
Administration, the Department of Labor and Employment reserves
the right to cancel the processing of my application;

4.

That I understand that should I be employed, any

misrepresentation on that matter is a ground for an administrative
case and termination;

5.

That this affidavit is executed to attest to the veracity of the

foregoing statements.

AFFIANT FURTHER SAYETH NAUGHT.

In Manila, this 26TH day of November, 2016

JUAN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN TO before me this 26 TH day of

November, 2016, at the City of Manila, affiant exhibiting to me his UP
Student Identification Card with Serial No. 1176, issued on January
2016 at Manila.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2015.