Affidavit: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 27

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Republic of the Philippines )

Province of Davao del Norte ) S.S.


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

AFFIDAVIT

I, MARIA RECCA L. IPIL, CPA, Filipino, of legal age, single and a resident of Purok
Gabayan II, Visayan Vilage, Tagum City, Davao del Norte, Philippines, after having been duly
sworn to an oath in accordance with law, do hereby depose and say:

That I am the Accountant of Medical Mission Group Hospital and Health Services
Cooperative of Tagum City (MMGHHSCT);

That I am aware of the admission and confinement of Krizza Kay A. Terado in Medical
Mission Group Hospital and Health Services Cooperative of Tagum City;

That Krizza Kay A. Terado was confined in a private room of MMGHHSCT for fifty-
three (53) days from October 9,2015 to December 1,2015;

That days after her confinement, I visited her along with her family in her room to update
them with their hospital billing;

That I made sure to keep them abreast with their hospital billing either personal or
through my staff;

I am executing this Affidavit, in order to attest the truth of the foregoing statement and to
inform the authorities hereof.

IN WITNESS WHEREOF, I have hereunto set my hand this 27th day of January 2017 in
Tagum City, Davao del Norte, Philippines.

RECCA IPIL
Affiant
PRC Identification Card No.0160289

SUBSCRIBED AND SWORN to before me this 27th day of January 2017 in Tagum City,
Davao del Norte, Philippines, affiant exhibited to me the above-mentioned Identification Card as
competent proof of her identity.

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