REPUBLIC OF THE PHILIPPINES}

BATANGAS CITY} S.S.

X-------------x

AFFIDAVIT

I, RYAN D. BACARON, of legal age, Filipino and a resident of Purok Yakal, Brgy. Dagatan,
San Jose, Batangas, after having been duly sworn according to law depose and say:

1. That I am the same RYAN D. BACARON who was issued the following documents to
wit:

a. Certification issued by the San Jose District Hospital,

A copy of which is hereto attached for easy reference;

2. That I guarantee the genuineness and authenticity of this document and that the
same may be authenticated;

3. That I am executing this Affidavit to to attest to the truth of the foregoing, to notify
the proper authorities, and for whatever legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this May 8, 2015 at Batangas City,
Philippines.

RYAN D. BACARON
Affiant

SUBSCRIBED AND SWORN to before me this May 8, 2015, at Batangas City, Philippines,
affiant, whom I have identified through competent evidence of identity exhibited his PRC ID No.
0593383.

ROBERTO IIGO D. SANCHEZ

Notary Public
Until December 31, 2015
PTR No.2336340 01.05.2015 Bats. City
Doc. No. 158; IBP No. 945056 01.05.2015 Bats. City
Page No. 33; Roll No. 61644 Serial No. 2014-33
Book No. VIII; Zenaida Arcade, 43 M.H. Del Pilar St., Batangas City
Series of 2015 MCLE Compliance Certificate No. IV-0015192