REPUBLIC OF THE PHILIPPINES

Province of Negros Occidental) S.S.

City of Bacolod)

AFFIDAVIT OF EMPLOYMENT

I, AIRES S. CUSTODIO, of legal age, Filipino, with residence at Pescador St.,

Brgy. Poblacion, Municipality of San Enrique, Negros Occidental, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and say:

1. That I am a degree holder of Bachelors of Science in Nursing obtained from

the University of St. La Salle Bacolod on March 2009;

2. That my credentials and scholastic records enabled me to be gainfully

employed in several hospitals in the Province of Negros Occidental;

3. That the following are the employments I had since graduating from the
University of St. La Salle Bacolod:

a) CORAZON LOCSON MONTELIBANO MEMORIAL REGIONAL

HOSPITAL (CLMMRH) as STAFF NURSE assigned at the Out-
Patient Department (OPD) from December 15, 2014 to November
14, 2016 and at the 4th Floor West Tower Building from November
15, 2016 up to the present (Original copy of the Certification
issued by MARIA GELIA N. ONG, DPA in her capacity as the
Supervising Administrative Officer is herein attached as Annex
“A”);

b) DON SALVADOR BENEDICTO MEMORIAL HOSPITAL as STAFF

NURSE from May 19, 2010 to May 19, 2012 (Original Copy of the
Certification issued by JOCELYN C. GELOGO, RN. MBA. MN in her
capacity as Nurse IV, approved by GABBY P. PALACIOS, MD, MBA-
HA in her capacity as Chief of Hospital I is herein attached as
Annex “B”);

4. That I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purposes that this statement may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this _____ day of

_____________, 2018, in the City of Bacolod, Philippines.

AIRES S. CUSTODIO
AFFIANT

SUBSCRIBED AND SWORN to before me, this _____ day of ______________,

2018, by AIRES S. CUSTODIO, who exhibited to me her PRC ID (Reg. No. 0617386).

Doc No. _______

Page No. _______
Book No. _______
Series of 2018