Republic of the Philippines )

City of San Pablo )

Province of Laguna ) S.C.

AFFIDAVIT OF NON-FILING OF TAX RETURN

I, ________________________, of legal age, married, Filipino, with residence

at _____________________________, after having been duly sworn in accordance
with law, respectfully states:

1. I am the father/mother of __________________________.

2. As of this writing, my daughter is _____________ years old, and is

currently applying to ___________________________________________________,
for the incoming academic year.

3. As part of the requirements for her application, her parent’s income

tax return issued by the Bureau of Internal Revenue (BIR) should be submitted.

4. However, I do not have a regular job. Hence, I am exempt from filing

and payment of income tax, under the law.

5. I am executing this affidavit to request for a Certificate of Tax

Exemption from the BIR.

6. I am likewise executing this affidavit to attest the truth of the

foregoing, and for whatever legal purpose it may serve.

Affiant further sayeth naught.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _____

day of ___________, 2019 in the City of _______________________.

_________________________________
Affiant

SUBSCRIBED AND SWORN TO before me this ____ day of ____________

2019 in the City of _______________, affiant exhibiting his competent evidence of
identity_________________________________.