CCF 000029

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‘obeyieu jo joquike RENN TT sUjBYO 10 €981q pout eB mona ‘UjBUO J0 201 FYGA\N A305 Jeyowpueis 80 19 @08ig) TN on sau naan note TEM NOTE aNPDRy) W¥00 YODIN | stan Ngai vas |, won va JOUjBIPUB yeas} JAPOWPUBI AID) = J0yjespueI jeeIH)| eyJOWPUBIE * WxOs ADC sreujddyal 0410 ongndons SCREENING 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.

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