AFFIDAVIT

I, _______________________________________, Filipino, of
legal age, presently residing in _______________________________,
after having been duly sworn to in accordance with law do hereby
depose and state:

 That I am not in any way, by blood or affinity, related to Ms.

________________________, holder of Philippine
Passport No. ____________________, issued on
____________________ in
_________________________; and

 That this affidavit was executed for the purpose of acquiring

the services of Ms. ______________________, as my
housemaid, in Abu Dhabi;

 Affiant further sayeth naught.

______________________
Affiant

Republic of the Philippines

Province/City ___________) S.S.

SUBSCRIBED AND SWORN to before me this

________________,2016, Philippines. Affiant exhibiting his Community
Tax Certificate No. __________________ issued on
_____________________ in _________________________________.

Doc. No: ______ NOTARY PUBLIC

Page No: ______ Until: _________
Book No: ______ PTR No: ______
Series of _______ Date: _________
Place: ________
TIN: __________