Republic of the Philippines )

Province of Davao Del Norte )s.s

City of Tagum )
x-------------------------------x

AFFIDAVIT OF CONFIRMATION

I, , of legal age, Filipino, single, and a resident of ___________, after

having been duly sworn in accordance with law, hereby depose and say THAT:

1. On, , the _____________ issued a Certification verifying that I was

employed as a Pharmacist dated ;

2. By virtue of the Certification, I am currently under the employment

of the mentioned hospital;

3. Pursuant to the Certification issued by the ____________ and the

Affidavit of Employment I executed, I hereby affirm and confirm the
said documents which were issued and executed on , respectively;

4. I hold myself criminally and administratively liable for perjury and

dishonesty should any statements made herein are inaccurate or
later found to be false and in law.

5. I am executing this Affidavit to attest to the truthfulness of the

foregoing facts and for other legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this____________,

Philippines.

SUBSCRIBED AND SWORN to before me this ________________

Philippines, affiant exhibiting to me her competent evidence of identity written
below her name and signature.