Affidavit No Pending

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Republic of the Philippines )

Legazpi City ) S.S.

x- - - - - - - - - - - - - - - - - - -x

AFFIDAVIT

I, ___________________________, Filipino, of legal age, single, and a


resident of ________________________________________ Legazpi City,
Philippines, after having duly sworn to in accordance with law, hereby depose and
state that:

1. I am being recommended to be employed at the Department of Labor and


Employment as a TUPAD Program Coordinator;

2. I have no administrative, civil and/or criminal case filed or pending against


me before any court, tribunal or body at this time;

3. That if I should thereafter learn that a similar action or proceeding has


been filed or is pending before any court, tribunal or body. I undertake to
report that fact within five (5) days therefrom to this court, tribunal or body;

4. I am executing this affidavit/certification to attest to the truth of the


foregoing as pre-employment requirement of the Department of Labor and
Employment.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


____________ in the City of __________, Philippines.

______________________
Affiant

SUBSCRIBED AND SWORN to before me this ______________________ in


the City of __________, Philippines, affiant having exhibited to me her __________
with No. __________ issued on _______________ at _______________.

Doc. No. ______;


Page No. ______;
Book No. ______;
Series of 2021.

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