Affidavit of Low Income

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Republic of the Philippines )

Province of Capiz ) SS.


Municipality of Tapaz )
x- - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF LOW INCOME

We, Spouses _____________________and ______________________, both of


legal age, Filipino citizens and residents of Brgy. _________________,Tapaz , Capiz,
Philippines, after having been duly sworn to in accordance with law hereby depose and
state THAT:

1. We are the legitimate parents of _____________________________, a high


school graduate who is applying for a CHED Scholarship Program;

2. As seasonal farmer and housekeeper, respectively, we are low


income earners;

3. Our annual income of ________________________THOUSAND PESOS


(P______,000.00) is so meager and only enough to cover our daily needs;

4. We executed this affidavit to attest to the veracity of the above and in support
to our son's application for ascholarship program.

IN WITNESS WHEREOF, we have hereunto affixed our signatures this ____day


of ____________ 2017 at ____________, Philippines.

______________________ _________________________
Affiant Affiant

SUBSCRIBED AND SWORN TO before me this ___ day of _______ at


_______________ affiants exhibited to me their identification card number
______________and ______________issued on _____________ and
______________, respectively, in __________________________.
.

Doc. No. .......


Page No. ....... Notary Public
Book No. ......
Series of 2017.

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