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sreujddyal 0410 ongndonsSCREENING AND VERIFICATION COMMITTEE
NATIONAL COMMISSION INDIGENOUS PEOPLES.
REGIONAL OFFICE VI & VII
Ctrl Number
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF _ | )
MUNICIPALITY OF )
x
JOINT AFFIDAVIT
THAT WE, and
$d
and Years old, single’ married, Filipinos, members of WVMON BLRIDUON
(CC) and residents of Barangay. (tN.
to in accordance with law. do hereby dispose and say:
THAT WE, personally know a certain Person named
svbo ‘is @ resident and native of GE. FOMON (A EMEGIO, HIOUE
member of. (Tribe)
THAT the said HOW MERA is the daughter’son of
the spouses MONUL_f- MEQUILE ——— and HO PEO
who are residents of i a
THAT isa member of =
(Tribe) wherein her/his parents _ is also a member.
THAT WE are executing this affidavit to attest to the truth of the forgoing statements and
for the purpose of availing scholarship privilege granted to the members of the cultural
communities.
IN WITNESS WHEREOF, WE hereby affixed our signature this day of
aeeeeo Philippines.
PRINT NAME’SIGNATURE PRINT NAME/SIGNATURE
Senior Citizen ID No.__ Senior Citizen ID No.
Voters ID No, Voters ID No.___ i
SUBSCRIBED AND SWORN, to before me this
200__at
dayof_
in the Philippines.
Notary Public
(Curl Number.