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REPUBLIC OF THE PHILIPPINES ) PROVINCE OF CAMARINES NORTE )SS. MUNICIPALITY OF D A E T ) AFFIDAVIT I, JUANA L.

DACO, of legal age, Filipino citizen, married, and a resident of P-2, Brgy. Cobangbang, Daet, Camarines Norte, after having been duly sworn to in accordance with law, hereby depose and say: That I am a bonafide self-employed member of the SOCIAL SECURITY SYSTEM (SSS) with SS No. _____________________; That as of June 23, 2008, I have no more income from any kind of livelihood or business; That I am executing this affidavit to attest to the facts aforestated and for the purpose of supporting my application for retirement and to claim all benefits due me from the SSS. IN WITNESS WHEREOF, I have hereunto set my hand this 11th day of June, 2008, at Daet, Camarines Norte, Philippines.

JUANA L. DACO Affiant SUBSCRIBED AND SWORN to before me, this 10th day of June, 2008, at Daet, Camarines Norte. Doc. No._______ Page No._______ Book No._______ Series of 2008

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