Affidavit of Denial of Nbi Hit
Affidavit of Denial of Nbi Hit
Affidavit of Denial of Nbi Hit
AFFIDAVIT OF DENIAL
REPUBLIC OF THE PHILIPPINES )
_____________________________ ) SS.
I, (name of affiant), Filipino, of legal age, single/married to (name of spouse), and a resident of
(address of affiant), after having been duly sworn in accordance with law, hereby depose and
say:
1. That the NBI Office in Manila has advised me that said Office could not issue the required
clearance in view of the appearance of name similar to my name in NBI files involving in case/s
filed against said person bearing names similar to mine;
2. That I am executing this affidavit to attest to the foregoing facts and to deny categorically and
specifically under oath that I am not the same person mentioned in the docket/files of NBI with
the said derogatory/civil/criminal record/s;
In view of the foregoing, I am requesting NBI Office to issue the appropriate police clearance in
my favor for compliance with the certain requirements.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ____day of
____________ 20___ at ____________, Philippines.
_________________________________
(Signature of Affiant over Printed Name)
SUBSCRIBED AND SWORN TO before me, a notary public in and for
_____________________ this ____ day of ____________ 20___. The affiant, whom I identified
through the following competent evidence of identity: (ID type and number), valid from (date)
to (date) issued by (issuing authority), personally signed the foregoing instrument before me
and avowed under penalty of law to the whole truth of the contents of said instrument.
Notary Public
Doc. No. ..;
Page No. .;
Book No. .;
Series of 2010.