Affidavit of Indigency/Tax Exemption: - Affiant

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Republic 

of the Philippines )
Province of Camarines Sur ) 
City of Iriga  ) S.S.

AFFIDAVIT OF INDIGENCY/TAX EXEMPTION

I, --------, of legal age, Filipino, single and resident of San Jose, Iriga City,
Camarines Sur, Philippines, after having been duly sworn to in accordance with law,
do hereby depose and state that:

1. I am the father of ------- who is an incoming Grade 7 student applying for a


scholarship at the University of Saint Anthony of Iriga City

2. One of the requirements for the said scholarship is a tax exemption filed by
the parent with the Bureau of Internal Revenue;

3. I am an indigent with no sufficient income, as I only recently started to


work on a three-month job contract basis with the local government with a
salary of Php 7,000.00 a month and supporting four (4) children;

4. I am executing this Affidavit to attest to the foregoing facts and for the
purpose of securing a tax exemption from the Bureau of Internal Revenue,
and for any and all legal purposes this may serve.

IN WITNESS WHEREOF, I have set my hand this _____th day of May 2021 in
Iriga City, Camarines Sur, Philippines.

-----------
Affiant

BEFORE ME, a Notary Public in and for the City of Iriga, this _____th day of
May 2021, personally appeared the above-named person who presented to me his
___________________________ ID No. ________________, to prove that he is the
same person who voluntarily executed the foregoing AFFIDAVIT, which he
acknowledged before me as her free and voluntary act and deed.
WITNESS MY HAND AND SEAL.

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