Republic of the Philippines )

City of Cagayan de Oro ) Ss.

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AFFIDAVIT

I, MARY GRACE Q. ECHAVEZ, Filipino, of legal age and a resident of Initao,

Misamis Oriental, upon my oath, do hereby depose and state – That:

1. I am the Administrative Assistant III of Initao National Comprehensive

High School (INCHS) headed by our principal Mr. Adefer B. Caño.

2. In compliance with the requirements of the BIR, particularly Revenue

Regulation No. 2-2015 requiring the submission of Scanned Copies of
BIR Form 2317, I am submitting the scanned copies of the following
documents for and in behalf of INCHS:

a. Alphalist of Payees subject to Expanded Withholding Tax,

b. BIR Form 1604-E, and
c. BIR Form 2317.

3. I, Mary Grace Q. Echavez, further manifest that the information and/or

data provided in the foregoing documents are correct and accurate based
on my own personal knowledge.

4. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, We hereunto affix my signature this February

28, 2017, City of Cagayan de Oro, Philippines.

_____________________________
MARY GRACE Q. ECHAVEZ
Affiant

SUBSCRIBED AND SWORN to before me this February 28, 2017 in Cagayan de Oro City, affiant MARY GRACE Q. ECHAVEZ exhibiting to me
her DEPED ID No. 4255221 issued at Cagayan de Oro City I certify that I have examined the Affiant and I am satisfied that she had voluntarily
executed the foregoing Affidavit and that the contents thereof had been fully explained and understood by her before she affixed her signature
thereon.

Doc. No. 73
Page No. 15
Book No. III
Series of 2017.