REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAVITE ) S.S.

MUN. OF GEN. MARIANO ALVAREZ )

AFFIDAVIT OF NON-FILING OF INCOME TAX RETURN

I, JOCELYN FERNANDO AMOROSO of legal age, married and a resident of Brgy.

Maguyam, Silang, Cavite after having been duly sworn in accordance with law, hereby depose
and say:

1. That I am a Bananaque Vendor in Maguyam, Silang, Cavite and my husband is

jobless;

2. That my monthly income as a vendor is not more than SIX THOUSAND PESOS
(P6,000.00);

3. That I did not file my yearly income tax return believing that I am exempted due to
my income which is below minimum wage;

4. That I am the mother SOLEDAD FERNANDO AMOROSO who is a student of New Life
Christian School located at Maguyam, Silang, Cavite and an applicant for Department
of Education Voucher Program for Senior High School;

5. That I am executing this affidavit to attest to the monthly income I earned as

vendor and for not filing my yearly income tax return as a requirement for the said
Voucher Program my daughter was applying;

6. That this is further executed to request New Life Christian School – Maguyam,
Silang, Cavite to accept this affidavit in lieu of the required Income Tax Return in
compliance with the requirement of Voucher Program of Department of Education.

IN WITNESS WHEREOF I hereunto affixed my signature this 14th day of December, 2015
at Gen. Mariano Alvarez, Cavite.

JOCELYN FERNANDO AMOROSO

Affiant

SUBSCRIBED AND SWORN TO before me this 14th day of December, 2015, affiant
exhibited to me her Voter’s ID No. VIN: 2118-0286A-K1178JFA20005-3 issued by COMELEC-
Silang, Cavite as competent evidence of her identity.

ILUMINADA M. VAFLOR-FABROA
Notary Public Until December 31, 2016
Application No. 2014-19 12-22-14
P.T.R. No. CAV839009A 1-7-15 TMC, Cavite
IBP O.R. No. 951317 11-06-14 Cavite Chapter-Imus
Attorney’s Roll No. 21249 3-17-67
Congressional Ave. cor. Visayas Ave., Brgy. Maderan, GMA, Cavite

Doc. No. 663;

Page No. 29;
Book No. II;
Series of 2015.