Republic of the Philippines)

Province of Surigao del Sur)s.s.

Municipality of Tago . . . . .)
X- - - - - - - - - - - - - - - - - - - - - -/

AFFIDAVIT OF SEPARATION FROM EMPLOYMENT

I, ELPEDIO RAGAS CURAG, of legal age, Filipino, married and a

presently residing at Cortes, Surigao del Sur, Philippines after having been duly
sworn to in accordance with law hereby depose and say:

1. That I am a bonafide member of the Social Security

System with SSS number 08-0427034-0;

3. That I was separated from my last employer, KINTANAR

SECURITY AGENCY INC, with address 146 A Roosevelt
Avenue, San Francisco del Monte, Quezon City
sometime on April 2006 due to the closure of the
business of its client in Tandag City, Surigao del Sur,
where I served as a Security Personnel. Thereafter, I was
never again re-employed;

4. That I cannot secure a certification of separation from my

last employer because I could not reach them anymore;

5. That I am executing this affidavit to attest to the

truthfulness of the foregoing facts and to support my
claim for retirement at SSS.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 21 st day of

March 2017 in Tago, Surigao del Sur, Philippines.

ELPEDIO RAGAS CURAG

Affiant
SSS ID No. 08-0427034-0

SUBSCRIBED AND SWORN TO before me this 21st day of March 2017 in

Tago, Surigao del Sur, Philippines.